Diarrhea recurrence in patients with Clostridium difficile-associated diarrhea: Role of concurrent antibiotics.

The Canadian Journal of Infectious Diseases = Journal Canadien Des Maladies Infectieuses
M AlfaL Louie

Abstract

To monitor prospectively patients with Clostridium difficile-associated diarrhea (CAD) in a six hundred bed tertiary care hospital to determine which factors influenced the recurrence of the diarrhea. A prospective, nonrandomized study. After an initial diagnosis of CAD, patients were interviewed, and each week stool samples and environmental samples were monitored for the presence of toxigenic C difficile for as long as the patients remained in hospital. The relationship of concurrent antibiotics, prolonged fecal excretion of organism or toxin, and environmental contamination was assessed. Over a two-and-a-half year period, 75 consecutive patients with CAD were selected and those who gave their written informed consent were enrolled. A control group to evaluate environmental contamination consisted of 75 patients with diarrhea not associated with C difficile. Of the 75 CAD patients, 11 (14.7%) had a recurrence of their diarrhea. Diarrhea recurrence was associated with an increased rate of prolonged excretion of toxigenic organism and/or C difficile toxin(s) (nine of 11 [81.8%] compared with nine of 64 [14.1%]; P≤0.0001; relative risk 14.25; 95% CI 3.383 to 60.023). The risk of diarrhea recurrence was not related to a specific ...Continue Reading

Citations

Jan 2, 2014·Therapeutic Advances in Gastroenterology·Wallace J WangMoshe Rubin
Apr 30, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Charlesnika T Evans, Nasia Safdar
Mar 6, 2021·Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners·Kelli R KeatsAmber B Clemmons

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