Factors Affecting Treatment and Recurrence of Clostridium difficile Infections

• Matsumoto Kazuaki

  Department of Clinical Pharmacy and Pharmacology, Graduate School of Medical and Dental Sciences, Kagoshima University Kagoshima University Hospital, Infection Control Team

• Kanazawa Naoko

  Department of Clinical Pharmacy and Pharmacology, Graduate School of Medical and Dental Sciences, Kagoshima University Kagoshima University Hospital, Infection Control Team

• Shigemi Akari

  Department of Clinical Pharmacy and Pharmacology, Graduate School of Medical and Dental Sciences, Kagoshima University Kagoshima University Hospital, Infection Control Team

• Ikawa Kazuro

  Department of Clinical Pharmacotherapy, Hiroshima University

• Morikawa Norifumi

  Department of Clinical Pharmacotherapy, Hiroshima University

• Koriyama Toyoyasu

  Kagoshima University Hospital, Infection Control Team

• Orita Michiyo

  Kagoshima University Hospital, Infection Control Team

• Kawamura Hideki

  Kagoshima University Hospital, Infection Control Team

• Tokuda Koichi

  Kagoshima University Hospital, Infection Control Team

• Nishi Junichiro

  Kagoshima University Hospital, Infection Control Team

• Takeda Yasuo

  Department of Clinical Pharmacy and Pharmacology, Graduate School of Medical and Dental Sciences, Kagoshima University

書誌事項

タイトル別名

• Factors Affecting Treatment and Recurrence of <i>Clostridium difficile</i> Infections

抄録

The antimicrobial agents vancomycin and metronidazole have been used to treat Clostridium difficile infections (CDIs). However, it remains unclear why patients are at risk of treatment failure and recurrence. Therefore, this study retrospectively examined 98 patients with CDIs who were diagnosed based on the detection of toxin-positive C. difficile to determine the risk factors affecting drug treatment responses and the recurrence of CDI. No significant difference was observed in the cure rate or dosage between the vancomycin and metronidazole groups. The 90-d mortality rate and total number of drugs associated with CDIs, including antiinfective agents used within 2 months before the detection of toxin-positive C. difficile, were significantly lower in the treatment success group than in the failure group. The total number of antiinfective agents and gastric acid-suppressive agents used during CDI therapy was also significantly lower in the success group than in the failure group. The period from the completion of CDI therapy to restarting the administration of anticancer agents and steroids was significantly longer in patients without than in patients with recurrence. These results indicate that the total number of drugs associated with CDIs should be minimized to reduce the risk of CDIs, that not only antibiotics but also gastric acid-suppressive agents should be discontinued during CDI therapy to increase therapeutic efficacy, and that the use of anticancer agents and steroids should be delayed as long as possible after patients are cured by CDI therapy to prevent recurrence.

収録刊行物

• Ｂｉｏｌｏｇｉｃａｌ　＆　Ｐｈａｒｍａｃｅｕｔｉｃａｌ　Ｂｕｌｌｅｔｉｎ

  Ｂｉｏｌｏｇｉｃａｌ　＆　Ｐｈａｒｍａｃｅｕｔｉｃａｌ　Ｂｕｌｌｅｔｉｎ 37 (11), 1811-1815, 2014

  公益社団法人 日本薬学会

キーワード

• <i>Clostridium difficile</i>
• antiinfective agent
• gastric acid-suppressive agent
• anticancer agent
• steroid
• recurrence

詳細情報

• CRID: 1390001204633780864
• NII論文ID: 130004703902
• NII書誌ID: AA10885497
• DOI: 10.1248/bpb.b14-00492
• ISSN: 13475215
• ISSN: 09186158
• NDL書誌ID: 025880574
• PubMed: 25366486
• Web Site: http://ir.lib.hiroshima-u.ac.jp/00046717
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I025880574
• Web Site: https://www.jstage.jst.go.jp/article/bpb/37/11/37_b14-00492/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2015248463
• 本文言語コード: en
• データソース種別:
  • JaLC
  • IRDB
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
• 抄録ライセンスフラグ: 使用不可