Treating Clostridium difficile infection

A randomized controlled trial (RCT) showed that metronidazole was as effective as vancomycin taken orally for the treatment of mild Clostridium difficile infection. However, in cases of severe infection, 97% of patients given vancomycin had clinical resolution compared with only 76% of those given m...

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Bibliographic Details
Published in:Canadian Medical Association journal (CMAJ) 2014-04, Vol.186 (7), p.531-531
Main Authors: Shafran, Daniel M, Shafran, Stephen D
Format: Article
Language:English
Subjects:
Aminoglycosides - therapeutic use
Anti-Bacterial Agents - therapeutic use
Antibacterial agents
Antibiotics
Bacterial infections
Bacterial Vaccines - therapeutic use
Care and treatment
Clostridium difficile - isolation & purification
Drug therapy
Enterocolitis, Pseudomembranous - microbiology
Enterocolitis, Pseudomembranous - therapy
Health aspects
Humans
Infection
Practice
Probiotics - therapeutic use
Randomized Controlled Trials as Topic
Treatment Outcome
Vancomycin - therapeutic use
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Description
Summary:A randomized controlled trial (RCT) showed that metronidazole was as effective as vancomycin taken orally for the treatment of mild Clostridium difficile infection. However, in cases of severe infection, 97% of patients given vancomycin had clinical resolution compared with only 76% of those given metronidazole.1 The Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America recommend metronidazole as first-line therapy for mild or moderate C. difficile infection and vancomycin for severe infection (Box 1).2Although criteria for severe infection differ between guideline and trial, both include a leukocyte count greater than 15 × 109 cells/L
ISSN:0820-3946
1488-2329
DOI:10.1503/cmaj.131315