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Risk Factors for Treatment Failure and Recurrence after Metronidazole Treatment for Clostridium difficile-associated Diarrhea

Authors
 Kyu Sik Jung  ;  Jae Jun Park  ;  Young Eun Chon  ;  Eun Suk Jung  ;  Hyun Jung Lee  ;  Hui Won Jang  ;  Kyong Joo Lee  ;  Sang Hoon Lee  ;  Chang Mo Moon  ;  Jin Ha Lee  ;  Jae Kook Shin  ;  Soung Min Jeon  ;  Sung Pil Hong  ;  Tae Il Kim  ;  Won Ho Kim  ;  Jae Hee Cheon 
Citation
 Gut and Liver, Vol.4(3) : 332-337, 2010 
Journal Title
 Gut and Liver 
ISSN
 1976-2283 
Issue Date
2010
Abstract
BACKGROUND/AIMS: The incidence of treatment failure or recurrence of Clostridium difficile-associated diarrhea (CDAD) following metronidazole treatment has increased recently. We studied the treatment failure, recurrence rate, and risk factors predictive of treatment failure and recurrence after metronidazole treatment for CDAD. METHODS: We retrospectively identified consecutive patients who were admitted and treated for CDAD at a single tertiary institution in Korea over a recent 10-year period (i.e., 1998-2008). RESULTS: Metronidazole was administered as the initial treatment to 111 of 117 patients (94.9%) with CDAD. Fourteen patients (12.6%) had no clinical response to the metronidazole treatment, and in 13 patients (13.4%) CDAD recurred after successful metronidazole treatment. Diabetes mellitus (p=0.014) and sepsis (p=0.002) were independent risk factors for metronidazole treatment failure. Patients who had received surgery within 1 month before CDAD developed were more likely to experience a recurrence after metronidazole treatment (p=0.032). Vancomycin exhibited a higher response rate after treatment failure, and metronidazole showed a reasonable response rate in the treatment of recurrence. Treatment failure and recurrence rates increased with time after metronidazole treatment for CDAD over the 10-year study period. CONCLUSIONS: Our data suggest that diabetes mellitus and sepsis are independent risk factors for metronidazole treatment failure, and that operation history within 1 month of development of CDAD is a predictor of a recurrence after metronidazole treatment.
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DOI
10.5009/gnl.2010.4.3.332
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pharmacology (약리학교실) > 1. Journal Papers
Yonsei Authors
김원호(Kim, Won Ho) ORCID logo https://orcid.org/0000-0002-5682-9972
김태일(Kim, Tae Il) ORCID logo https://orcid.org/0000-0003-4807-890X
문창모(Moon, Chang Mo)
박재준(Park, Jae Jun)
신재국(Shin, Jae Kook)
이경주(Lee, Kyong Joo)
이현정(Lee, Hyun Jung)
장희원(Jang, Hui Won)
전승민(Jeon, Soung Min)
전영은(Chon, Young Eun)
정규식(Jung, Kyu Sik)
정은석(Jung, Eun Suk)
천재희(Cheon, Jae Hee) ORCID logo https://orcid.org/0000-0002-2282-8904
홍성필(Hong, Sung Pil)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101640
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