Factors affecting treatment and recurrence of Clostridium difficile infections

Kazuaki Matsumoto, Naoko Kanazawa, Akari Shigemi, Kazuro Ikawa, Norifumi Morikawa, Toyoyasu Koriyama, Michiyo Orita, Hideki Kawamura, Koichi Tokuda, Junichiro Nishi, Yasuo Takeda

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1811-1815
Number of pages5
JournalBiological and Pharmaceutical Bulletin
Volume37
Issue number11
DOIs
Publication statusPublished - 2014 Nov 1

Keywords

  • Anticancer agent
  • Antiinfective agent
  • Clostridium difficile
  • Gastric acid-suppressive agent
  • Recurrence
  • Steroid

ASJC Scopus subject areas

  • Pharmacology
  • Pharmaceutical Science

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  • Cite this

    Matsumoto, K., Kanazawa, N., Shigemi, A., Ikawa, K., Morikawa, N., Koriyama, T., Orita, M., Kawamura, H., Tokuda, K., Nishi, J., & Takeda, Y. (2014). Factors affecting treatment and recurrence of Clostridium difficile infections. Biological and Pharmaceutical Bulletin, 37(11), 1811-1815. https://doi.org/10.1248/bpb.b14-00492