TY - JOUR
T1 - Clostridium difficile colitis
T2 - Factors influencing treatment failure and relapse a prospective evaluation
AU - Nair, Satheesh
AU - Yadav, Dhiraj
AU - Corpuz, Marilou
AU - Pitchumoni, C. S.
N1 - Copyright:
Copyright 2007 Elsevier B.V., All rights reserved.
PY - 1998/10
Y1 - 1998/10
N2 - Objective: The aim of this study was to identify patient related factors that may influence the treatment response and relapse following Clostridium difficile (C. difficile) colitis. Methods: A total of 36 patients with C. difficile colitis were followed for 3 months. Age, sex, place of residence, severity of infection, treatment, underlying medical condition, and treatment were compared in patients who failed to respond to treatment in 14 days and in patients who relapsed after a successful treatment. Student's t test and Fisher's exact test were used to compare the groups. A p value of <0.05 was considered significant. Results: A low serum albumin (p = 0.016) and continuation of systemic antibiotic treatment were found to be associated with refractoriness to treatment. Continuation or restarting of antibiotics after successful treatment increases the risk of relapse (p = 0.003). The age, sex place of residence, underlying medical condition, and type of precipitating antibiotics had no effect on the treatment response and relapse. The severity of colitis and the type of therapy (metronidazole vs vancomycin) did not influence the treatment response or relapse. Conclusion: Low serum albumin serves as a useful marker for patients who require prolonged treatment for C. difficile colitis. It is prudent to review the need for the continuation of systemic antibiotic treatment, as it adversely affects the treatment response and increases the risk of relapse.
AB - Objective: The aim of this study was to identify patient related factors that may influence the treatment response and relapse following Clostridium difficile (C. difficile) colitis. Methods: A total of 36 patients with C. difficile colitis were followed for 3 months. Age, sex, place of residence, severity of infection, treatment, underlying medical condition, and treatment were compared in patients who failed to respond to treatment in 14 days and in patients who relapsed after a successful treatment. Student's t test and Fisher's exact test were used to compare the groups. A p value of <0.05 was considered significant. Results: A low serum albumin (p = 0.016) and continuation of systemic antibiotic treatment were found to be associated with refractoriness to treatment. Continuation or restarting of antibiotics after successful treatment increases the risk of relapse (p = 0.003). The age, sex place of residence, underlying medical condition, and type of precipitating antibiotics had no effect on the treatment response and relapse. The severity of colitis and the type of therapy (metronidazole vs vancomycin) did not influence the treatment response or relapse. Conclusion: Low serum albumin serves as a useful marker for patients who require prolonged treatment for C. difficile colitis. It is prudent to review the need for the continuation of systemic antibiotic treatment, as it adversely affects the treatment response and increases the risk of relapse.
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U2 - 10.1016/S0002-9270(98)00422-5
DO - 10.1016/S0002-9270(98)00422-5
M3 - Article
C2 - 9772047
AN - SCOPUS:0032435128
SN - 0002-9270
VL - 93
SP - 1873
EP - 1876
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
IS - 10
ER -