Could Amoxicillin Raise the Risk of Diarrhea and Candidiasis?

Taking the antibiotics amoxicillin and amoxicillin-clavulanic acid could result in candidiasis and diarrhea and the adverse impact could be under-reported, according to a recent study.

In order to better determine the risk of adverse effects while taking the antibiotics, researchers conducted a review that included 45 trials with a total of 10,519 participants. Of the trials, 27 involved the use of amoxicillin, 17 involved the use of amoxicillin-clavulanic acid, and 1 trial involved both of the drugs.
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Antibiotics were prescribed by primary care physicians in 15 studies, for the purpose of dental care in 9 studies, for the purpose of treatment in 25 studies, and for the purpose of prevention in 20 studies.

The review showed that participants taking amoxicillin-clavulanate and participants receiving amoxicillin were more than 3 times as likely and twice as likely to have diarrhea, respectively. Further, researchers discovered an association between amoxicillin-clavulanic acid use and the development of candidiasis.

Investigators noted that despite these results, under-reporting of the drugs’ adverse effects is still widespread among healthcare providers.

“Harms were poorly reported in most trials, and their true incidence may have been higher than reported. Nevertheless, these rates of common harms associated with amoxicillin therapy may inform decisions by helping clinicians to balance harms against benefits,” said the study’s authors.

The complete study is published in the November issue of the Canadian Medical Association Journal.

-Michelle Canales

Reference:

1. Gillies M, Ranakusuma A, Hoffmann T, et al. Common harms from amoxicillin: a systematic review and meta-analysis of randomized placebo-controlled trials for any indication. CMAJ. 2014 November [epub ahead of print] doi: 10.1503/cmaj.140848.