Three Cases of Antibiotic-Associated Hemorrhagic Colitis after Second-Line Therapy for Helicobacter Pylori

In our hospital, there were 314 cases of second-line therapy for Helicobacter pylori (H.pylori) with Metronidazole in the two years from February 2013 to January 2015. Three of the 314 cases were complicated with antibiotic-associated hemorrhagic colitis (AAHC). Case 1 was a 58-year-old woman, case 2 was a 54-year-old man, and case 3 was a59-year-old woman. All patients had onset for abdominal pain and bloody diarrhea after second-line therapy for Helicobacter pylori. Colonoscopy or abdominal CT scans showed edematous or wall thickness between the ascending colon and the sigmoid colon. They were relieved with fast treatment, fluid replacement, and administration of Clostridium butyricum in a few days, and had a good prognosis. Reports of AAHC after second-line therapy for H.pylori are rare, but it is thought that second-line therapy is increasing, and so careful monitoring for side effects is required.