Incidence and Risk Factors for Antibiotic-associated Diarrhea Among Hospitalized Children

Pediatr Infect Dis J. 2023 Sep 1;42(9):745-749. doi: 10.1097/INF.0000000000003994. Epub 2023 Jun 9.


Background: We aimed to evaluate the incidence, clinical findings, and risk factors of antibiotic-associated diarrhea (AAD) in hospitalized children without known comorbid diseases.

Methods: All hospitalized children during the 1-year period that fulfilled the inclusion criteria were included in this study (n = 358). AAD was defined as; ≥2 loose or watery stools per day for a minimum of 24 hours during antibiotic treatment caused by Clostridioides difficile or negative stool tests for identifiable infectious agents.

Results: During hospitalization, diarrhea developed in 32 (8.93%) of the 358 patients. C. difficile toxin B was positive for 1 case. No infectious agents were detected in 21 patients. Overall, AAD was observed in 22 patients (6.14%, 95% CI: 4.09-9.13). Male sex ( P = 0.027, OR: 3.36), age between 1 month and <3 years ( P = 0.01, OR: 4.23), ibuprofen use ( P = 0.044, OR: 2.63) and late administration of antibiotics ( P = 0.001, OR: 9.5) were associated with the development of AAD.

Conclusions: The incidence of AAD is low among hospitalized children without comorbid diseases, and most diarrheal episodes are mild and self-limiting. The use of probiotics in this patient group may be limited to certain specific situations.

MeSH terms

  • Anti-Bacterial Agents / adverse effects
  • Bacterial Toxins*
  • Child
  • Child, Hospitalized
  • Clostridioides difficile*
  • Diarrhea / epidemiology
  • Humans
  • Incidence
  • Infant
  • Male
  • Probiotics* / therapeutic use
  • Risk Factors


  • Bacterial Toxins
  • Anti-Bacterial Agents