scholarly journals Incidence and Clinical Outcomes of Clostridium difficile Infection after Treatment with Tuberculosis Medication

Gut and Liver ◽  
2016 ◽  
Vol 10 (2) ◽  
pp. 250 ◽  
Author(s):  
Yu Mi Lee ◽  
Kyu Chan Huh ◽  
Soon Man Yoon ◽  
Byung Ik Jang ◽  
Jeong Eun Shin ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clinical Outcomes ◽  
Clostridium Difficile Infection

scholarly journals What Is the Role for Metronidazole in the Treatment of Clostridium difficile Infection? Results From a National Cohort Study of Veterans With Initial Mild Disease

2018 ◽  
Vol 69 (8) ◽  
pp. 1288-1295 ◽  
Author(s):  
Haley J Appaneal ◽  
Aisling R Caffrey ◽  
Kerry L LaPlante
Keyword(s):  
Clostridium Difficile ◽  
Clinical Outcomes ◽  
Clostridium Difficile Infection ◽  
Proportional Hazards ◽  
Therapeutic Option ◽  
Cox Proportional Hazards ◽  
First Episode ◽  
Mild Disease ◽  
All Cause Mortality ◽  
National Cohort

Abstract Background Metronidazole may still be an appropriate therapeutic option for mild Clostridium difficile infection (CDI) in select patients, but data are limited to guide clinicians in identifying these patients. Methods Our 2-stage study included a national cohort of Veterans with a first episode of mild CDI (2010–2014). First, among those treated with metronidazole, we identified predictors of success, defined as absence of all-cause mortality or recurrence 30 days posttreatment, using multivariable unconditional logistic regression. Second, among a subgroup of patients with characteristics predictive of success identified in the first stage, we compared clinical outcomes among those treated with metronidazole compared with vancomycin, using Cox proportional hazards models for time to 30-day all-cause mortality, CDI recurrence, and failure. Results Among 3656 patients treated with metronidazole, we identified 3282 patients with success and 374 patients without success (failure). Younger age was the only independent predictor of success. Age ≤65 years was associated with an odds of success 1.63 times higher (95% confidence interval [CI], 1.29–2.06) than age >65 years. Among 115 propensity score–matched pairs ≤65 years of age, no significant differences were observed between metronidazole and vancomycin (reference) for all-cause mortality (hazard ratio [HR], 0.29 [95% CI, .06–1.38]), CDI recurrence (HR, 0.62 [95% CI, .26–1.49]), or failure (HR, 0.50 [95% CI, .23–1.07]). Conclusions Among patients ≤65 years of age with initial mild CDI, clinical outcomes were similar with metronidazole and vancomycin. These data suggest that metronidazole may be considered for the treatment of initial mild CDI among patients 65 years of age or younger.

Lack of Benefit With Combination Therapy for Clostridium difficile Infection

2017 ◽  
Vol 38 (5) ◽  
pp. 602-605
Author(s):  
Jessica C. Njoku ◽  
Trevor C. Van Schooneveld ◽  
Mark E. Rupp ◽  
Keith M. Olsen ◽  
Fang Qiu ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Combination Therapy ◽  
Confidence Interval ◽  
Clinical Outcomes ◽  
Clostridium Difficile Infection ◽  
Infect Control Hosp ◽  
Limited Data ◽  
Duration Of Therapy ◽  
Prolonged Duration

Limited data exist regarding combination therapy for Clostridium difficile infection (CDI). After adjusting for confounders in a cohort of patients with CDI and≥1 year old, combination therapy was not associated with significant differences in clinical outcomes, but it was associated with prolonged duration of therapy (1.22 days; 95% confidence interval, 1.03–1.44 days; P=.02).Infect Control Hosp Epidemiol 2017;38:602–605

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