Retrospective study of the efficacy and safety of metronidazole and vancomycin for Clostridioides difficile infection

Clinical Efficacy of Therapeutic Agents for <i>Clostridioides difficile</i> Infection Based on Four Severity Classifications

“…Conversely, no significant difference in the diarrhea cure rates between VCM and oral MNZ was reported in Japan (11,12), similar to the present study. Furthermore, in some reports, the recurrence rate of CDI was not related to severity (4,9,12). The 30-day mortality was higher in the VCM group than in the oral MNZ group in this study, which may be related to the fact that more patients in the VCM group received anticancer agents within 2 weeks before the onset of CDI, and the percentage of patients with a CCI of ≥ 3 tended to be Regarding CDI severity classification, no severity classification has a stable and reliable predictive ability (13), while MN criteria revealed severe and super-severe cases were significantly associated with 30-day mortality (14).…”

“…These reports, as well as the meta-analysis based on the Japanese guidelines, support the use of VCM for severe cases (10). Conversely, no significant difference in the diarrhea cure rates between VCM and oral MNZ was reported in Japan (11,12), similar to the present study. Furthermore, in some reports, the recurrence rate of CDI was not related to severity (4,9,12).…”

The frequency and duration of side-effects associated with the use of oral metronidazole; A prospective study of VITA trial participants

“…This is in contrast to the findings in a study of MTZ treatment for Clostridioides difficile infection in men and women, where a higher incidence of nausea was observed in younger patients (mean age in years [SD], 52 [21] vs 68 [15]; Nausea vs 'no' nausea, p < 0.05). 7 This study also found a higher incidence of nausea in women (14%) compared to men (1%). Dissimilarities in the study population (older participants), indication (Clostridioides difficile infection), treatment dose (1000 mg and 1500 mg oral metronidazole), and duration of treatment may account for differences compared to our data.…”

“…Likewise, it is not known whether patient characteristics influence susceptibility to MTZ associated AEs. 7,8 Accurate information about the frequency, duration and likely risk factors of MTZ side effects are needed to assist in the decision on whether to prescribe and to provide relevant information to patients. 9,10 The aim of this study was to prospectively describe the frequency, time to onset and duration of MTZ adverse effects (AE) and explore associated factors in women treated for BV with oral MTZ.…”