Metronidazole in the prevention of antibiotic-associated diarrhoea and Clostridium difficile infection in high-risk hospitalised patients

Gastroenterología y hepatología
Marco Tobar-MarcilloIxel Rivas-Bucio

Abstract

In-hospital diarrhoea has a high impact on morbidity and mortality rates among hospitalised patients. Chemoprophylaxis with antibiotics in selected patients could be a cost-effective tool for prevention. A prospective randomised, open-label study was conducted in a tertiary hospital in Mexico City, selecting patients at high risk of acquiring in-hospital diarrhoea and assigning them to a group taking metronidazole 500mg orally every eight hours for seven days or an observation group. The primary endpoint was the presence of antibiotic-associated diarrhoea and Clostridium difficile (C. difficile) infection during the seven days of evaluation. The study was approved by the institutional ethics committee. Registration number (11.2017) of 14 March 2017. Of the 116 patients who met the inclusion criteria, 96 were analysed, 41 in the intervention group and 55 in the observation group: 4.9% of patients in the intervention group and 16.4% in the observation group developed antibiotic-associated diarrhoea (odds ratio [OR] 0.26 (0.05-1.29); p =.109). 0% of patients in the intervention group and 9.1% in the observation group developed C. difficile infection (odds ratio [OR] 0.91 (0.84-0.99); p =.069). Metronidazole prophylaxis did not res...Continue Reading

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