Involvement of bacteria other than Clostridium difficile in antibiotic-associated diarrhoea

Antibiotic-associated diarrhoea (AAD) is a common and unintended consequence of antibiotic use. Clostridium difficile is the most common infectious aetiology of AAD; however, only approximately 25% of all AAD cases are associated with C. difficile infection, with the aetiology in the majority of cases remaining undetermined. Numerous other bacterial infectious agents have been implicated in AAD, including Clostridium perfringens, Staphylococcus aureus, and Klebsiella oxytoca. AAD is a complex disease that is influenced by the host, the infectious agent involved, and numerous clinical factors, including antibiotic treatment regimes. This review re-examines AAD and presents current perspectives on this disease, with a particular focus on the current understanding of bacterial causes other than C. difficile and the virulence factors involved in pathogenesis.