Clostridium difficile diarrhea and colonization after treatment with abdominal infection regimens containing clindamycin or metronidazole

Article Abstract:

Infections within the abdomen are associated with complications and a high mortality. Antibiotics are important in their treatment. Therapy with an aminoglycoside in conjunction with clindamycin is the standard against which new antibiotic regimens are evaluated. In this study 156 patients with abdominal infections were treated with one of three different antibiotic regimens. The purpose was to determine which regimen was most effective, and to assess the incidence of complications from infection with the bacteria Clostridium difficile. Clostridium difficile diarrhea is a frequent complication of antibiotic treatment, to the extent that it was once thought that the antibiotics themselves were to blame for the diarrhea. The antibiotic regimens compared were: Group 1. amikacin/metronidazole/placebo, used for 56 patients; Group 2. amikacin/clindamycin/placebo, used for 57 patients; Group 3. amikacin/clindamycin/ampicillin, for 43 patients. Clostridium difficile diarrhea occurred in a total of 15 patients and formation of Clostridium difficile colonies occurred in 14 patients. The number of group 1 patients (3 of 56) developing diarrhea was significantly lower than seen in group 2 (9 of 57), but not significantly lower than group 3 (3 of 43). When patients who had received other antibiotics within the last 30 days were excluded from the results, none of the 13 patients remaining in group 1 either developed diarrhea or colonization of C. difficile. However, of the 45 patients whose regimens included clindamycin, 14 colonized Clostridium difficile. These results suggest that use of metronidazole can reduce complications of Clostridium difficile, especially if additional non-aminoglycoside antibiotics are avoided. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Antibiotics, Clostridium infections, Metronidazole, Medical bacteriology, Clindamycin

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Epidemics of diarrhea caused by a clindamycin-resistant strain of Clostridium difficile in four hospitals

Article Abstract:

Widespread use of the antibiotic clindamycin in hospitals may have been responsible for an outbreak of diarrhea caused by Clostridium difficile in four different hospitals. Clostridium difficile is a bacterium that can cause diarrhea. Researchers analyzed Clostridium difficile isolated from patients affected by the outbreak and patients who were not. The use of clindamycin was strongly linked to the outbreaks. Also, all the strains of Clostridium isolated from patients with Clostridium-related diarrhea were resistant to clindamycin. Only 15% of strains not associated with the outbreaks were resistant to clindamycin.

Drug resistance in microorganisms, Microbial drug resistance, Clostridium, Epidemics

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Acquisition of Clostridium difficile and Clostridium difficile--Associated Diarrhea in Hospitalized Patients Receiving Tube Feeding

Article Abstract:

Hospital patients who are receiving tube feeding may have a higher risk of diarrhea caused by the bacterium Clostridium (C.) difficile. C. difficile is the most common infectious cause of diarrhea in hospital patients. In a study of 76 tube-fed hospital patients and 76 hospital patients who were not tube fed, 20% of the tube-fed patients became infected with C. difficile and 9% developed diarrhea. In contrast, only 8% of those not tube fed became infected and only 1% developed diarrhea.

Risk factors, Hospital patients, Nosocomial infections, Cross infection, Enteral feeding, Enteral nutrition

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