Relatively Poor Outcome after Treatment of Clostridium difficile Colitis with Metronidazole
Top Cited Papers
Open Access
- 1 June 2005
- journal article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 40 (11), 1586-1590
- https://doi.org/10.1086/430311
Abstract
Clostridium difficile is a frequent cause of serious nosocomial infection. Earlier reports have suggested that treatment with metronidazole cured nearly 90% of patients, with only a modest rate of recurrence of infection. In recent years, the rate of response to treatment with this drug has appeared to be much lower. We undertook a prospective, observational study of 207 patients who were treated with metronidazole for C. difficile colitis. A total of 103 patients (50%) were cured by the initial course of therapy and had no recurrence of disease. Forty-six patients (22%) continued to have symptoms of colitis for ⩾10 days despite treatment, and 58 (28%) responded initially but had a recurrence within the ensuing 90 days. The mortality rate among patients who developed C. difficile colitis was 27%, and it was higher among patients who did not respond fully to an initial course of therapy, compared with those who did (33% vs. 21%; P < .05). Because of the relatively poor response to therapy, additional approaches to prevention and/or treatment of C. difficile colitis appear to be warranted.Keywords
This publication has 27 references indexed in Scilit:
- Molecular Epidemiology of Hospital-Associated and Community-Acquired Clostridium difficile Infection in a Swedish CountyJournal of Clinical Microbiology, 2004
- Clindamycin, Cephalosporins, Fluoroquinolones, andClostridium difficile–Associated Diarrhea: This Is an Antimicrobial Resistance ProblemClinical Infectious Diseases, 2004
- Antibiotic-Associated DiarrheaThe New England Journal of Medicine, 2002
- Clostridium difficile–Associated DiarrheaArchives of Internal Medicine, 2001
- Clostridium difficile colitis: factors influencing treatment failure and relapse—a prospective evaluationThe American Journal of Gastroenterology, 1998
- Clostridium difficile–Associated DiarrheaClinical Infectious Diseases, 1998
- Ten Years of Prospective Clostridium difficile-Associated Disease Surveillance and Treatment at the Minneapolis VA Medical Center, 1982-1991Infection Control & Hospital Epidemiology, 1994
- Treatment of Antibiotic-Associated Pseudomembranous ColitisClinical Infectious Diseases, 1984
- PROSPECTIVE RANDOMISED TRIAL OF METRONIDAZOLE VERSUS VANCOMYCIN FOR CLOSTRIDIUM-DIFFICILE-ASSOCIATED DIARRHOEA AND COLITISThe Lancet, 1983
- Treatment of Clostridium difficile colitis and diarrhea with vancomycinAmerican Journal Of Medicine, 1981