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

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Author(s)

    • Matsumoto Kazuaki 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

Abstract

The antimicrobial agents vancomycin and metronidazole have been used to treat <i>Clostridium difficile</i> 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 <i>C. difficile</i> 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 <i>C. difficile</i>, 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.

Journal

  • Biological and Pharmaceutical Bulletin

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

    The Pharmaceutical Society of Japan

Codes

  • NII Article ID (NAID)
    130004703902
  • NII NACSIS-CAT ID (NCID)
    AA10885497
  • Text Lang
    ENG
  • Article Type
    journal article
  • ISSN
    0918-6158
  • NDL Article ID
    025880574
  • NDL Call No.
    Z53-V41
  • Data Source
    NDL  IR  J-STAGE 
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