| Risk Factors for Treatment Failure and Recurrence after Metronidazole Treatment for Clostridium difficile-associated Diarrhea. | |
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MedLine Citation:
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PMID: 20981209 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND/AIMS: The incidence of treatment failure or recurrence of Clostridium difficile-associated diarrhea (CDAD) following metronidazole treatment has increased recently. We studied the treatment failure, recurrence rate, and risk factors predictive of treatment failure and recurrence after metronidazole treatment for CDAD. METHODS: We retrospectively identified consecutive patients who were admitted and treated for CDAD at a single tertiary institution in Korea over a recent 10-year period (i.e., 1998-2008). RESULTS: Metronidazole was administered as the initial treatment to 111 of 117 patients (94.9%) with CDAD. Fourteen patients (12.6%) had no clinical response to the metronidazole treatment, and in 13 patients (13.4%) CDAD recurred after successful metronidazole treatment. Diabetes mellitus (p=0.014) and sepsis (p=0.002) were independent risk factors for metronidazole treatment failure. Patients who had received surgery within 1 month before CDAD developed were more likely to experience a recurrence after metronidazole treatment (p=0.032). Vancomycin exhibited a higher response rate after treatment failure, and metronidazole showed a reasonable response rate in the treatment of recurrence. Treatment failure and recurrence rates increased with time after metronidazole treatment for CDAD over the 10-year study period. CONCLUSIONS: Our data suggest that diabetes mellitus and sepsis are independent risk factors for metronidazole treatment failure, and that operation history within 1 month of development of CDAD is a predictor of a recurrence after metronidazole treatment. |
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Authors:
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Kyu Sik Jung; Jae Jun Park; Young Eun Chon; Eun Suk Jung; Hyun Jung Lee; Hui Won Jang; Kyong Joo Lee; Sang Hoon Lee; Chang Mo Moon; Jin Ha Lee; Jae Kook Shin; Soung Min Jeon; Sung Pil Hong; Tae Il Kim; Won Ho Kim; Jae Hee Cheon |
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Publication Detail:
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Type: Journal Article Date: 2010-09-24 |
Journal Detail:
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Title: Gut and liver Volume: 4 ISSN: 1976-2283 ISO Abbreviation: Gut Liver Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-10-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101316452 Medline TA: Gut Liver Country: Korea (South) |
Other Details:
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Languages: eng Pagination: 332-7 Citation Subset: - |
Affiliation:
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Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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