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J Clin Microbiol. 2004 Mar;42(3):1203-6.

Antibiotic-associated diarrhea accompanied by large-scale alterations in the composition of the fecal microbiota.

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Department of Microbiology and Molecular Genetics, Infectious Diseases Unit, National Food Safety and Toxicology Center, Michigan State University, East Lansing, Michigan 48824, USA.


Alterations in the diversity of the gut microbiota are believed to underlie the development of antibiotic-associated diarrhea (AAD). A molecular phylogenetic analysis was performed to document temporal changes in the diversity of fecal bacteria of a patient who developed AAD. Antibiotic administration was associated with distinct changes in the diversity of the gut microbiota, including a marked decrease in the prevalence of butyrate-producing bacteria. Following the discontinuation of the antibiotic, resolution of diarrhea was accompanied by a reversal of these changes, providing the first direct evidence linking changes in the community structure of the gastrointestinal bacteria with the development of AAD.

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