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ID 46717
file
creator
Matsumoto, Kazuaki
Kanazawa, Naoko
Shigemi, Akari
Koriyama, Toyoyasu
Orita, Michiyo
Kawamura, Hideki
Tokuda, Koichi
Nishi, Junichiro
Takeda, Yasuo
subject
Clostridium difficile
antiinfective agent
gastric acid-suppressive agent
anticancer agent
steroid
recurrence
NDC
Medical sciences
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.
journal title
Biological and Pharmaceutical Bulletin
volume
Volume 37
issue
Issue 11
start page
1811
end page
1815
date of issued
2014-11-01
publisher
The Pharmaceutical Society of Japan
issn
0918-6158
1347-5215
ncid
publisher doi
naid
language
eng
nii type
Journal Article
HU type
Journal Articles
DCMI type
text
format
application/pdf
text version
publisher
rights
Copyright (c) 2014 The Pharmaceutical Society of Japan
relation url
department
Graduate School of Biomedical & Health Sciences