Therapy of Antibiotic-Associated Pseudomembranous Colitis

Tedesco, Francis J.; Napier, Jerold; Gamble, Willard; Chang, Te‐Wen; Bartlett, John G.

doi:10.1097/00004836-197903000-00007

Cited by 40 publications

(21 citation statements)

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“…57,84,85 Treatment with rifampin in combination with vancomycin 86 or with anion-binding resins such as colestipol or cholestyramine has been found to be helpful for some patients. 87 Adjunctive therapy with probiotic agents such as Saccharomyces boulardii [88][89][90] and Lactobacillus GG 91 has also been found to be effective in the management of a relatively small number of patients with recurrent C. difficile diarrhea. Further evaluation of treatment modalities for recurrent C. difficile colitis is required.…”

Section: Treatmentmentioning

confidence: 99%

Clostridium difficile-associated diarrhea in adults

Poutanen

Simor²

2004

Canadian Medical Association Journal

358

280

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CLOSTRIDIUM DIFFICILE is the most important cause of nosocomial diarrhea in adults. Illness may range from mild watery diarrhea to life-threatening colitis. An antecedent disruption of the normal colonic flora followed by exposure to a toxigenic strain of C. difficile are necessary first steps in the pathogenesis of disease. Diagnosis is based primarily on the detection of C. difficile toxin A or toxin B. First-line treatment is with oral metronidazole therapy. Treatment with oral vancomycin therapy should be reserved for patients who have contraindications or intolerance to metronidazole or who fail to respond to first-line therapy

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Section: Treatmentmentioning

confidence: 99%

Clostridium difficile-associated diarrhea in adults

Poutanen

Simor²

2004

Canadian Medical Association Journal

358

280

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“…96%-100% of pseudomembranous colitis cases, 60%-75% of antibiotic-associated colitis cases, and 11%-33% of cases with diarrhea due to antibiotic intake are associated with C. difficile [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42].…”

Section: Discussionmentioning

confidence: 99%

Pseudomemberanous Colitis following Cesarean Delivery with Adjunctive Intracolonic Vancomycin

Ahmadi¹,

Rezaee²,

Tanha³

et al. 2016

J Gynecol Res Obstet

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Journal of Gynecological Research and Obstetrics 055According to the operation report numerous adhesions were detected during surgery, many of which especially those in the uterine incision site had been released. The patient received one dose of prophylactic cefazolin after clamping of the umbilical cord. Before discharge (discharged with personal consent) she had gas passage and defecation.Three days after C/S the patient was hospitalized with a presumed ileus. At that point she seemed well and had no fever and tachycardia; the abdomen was distended; bowel sounds were normal. On palpation, tenderness in left lower quadrant without rebound was present. In chest auscultation no abnormal finding except dextrocardia was detected (Figures 1,2).Initially the patient was managed conservatively, laboratory tests and surgery consult were ordered.The patient was not allowed to take anything by mouth and it was well emphasised to her to stay mobile. Despite gas passage her abdominal distention fluctuated during the first two days of hospitalization. During this period the laboratory findings were normal, no leucocytosis was present and hemoglobin and electrolytes were normal. Just on abdominal x ray( upright and flat) hyperinflation was to be seen.After the second day, diarrhea and a 38 C fever were added to the patients' signs. The diarrhea contained greenish liquid with white cheese -like parts. The patient was not ill, the abdominal palpation revealed no change and the laboratory findings were still normal.On the third day, abdominal distention was noticeably increased and the abdomen became tenser. Emergent surgery and gastrointestinal consult were ordered and the patient was admitted to the intensive care unit. At that point potassium was as low as 2.4 IntroductionPseudomembranous colitis (PMC) is a type of colitis (and sometimes enteritis), with special pathologic and oftentimes radiologic features, which is usually associated with the overgrowth of a bacterium called Clostridium difficile. Although this condition normally occurs following antibiotic consumption, it may rarely happen in other settings such as bowel ischemia, intestinal obstruction, and intestinal surgery or chemotherapy. Moreover, gastrointestinal infections (e.g. Staphylococcus aureus) can induce a similar condition [1].A recent increase in the incidence rate and severity of clostridium difficile infection has been reported, which is thought to be due to the great use of broad spectrum antibiotics worldwide and the development of a hypervirulant strain of this organism [2][3][4]. The presentation of PMC can vary from a self-limiting diarrhea to toxic megacolon and death [5]. Yet, many cases have confusing clinical features and their condition may not be diagnosed immediately [1]. History of previous antibiotic intake especially cephalosporins and flouroquinolones is the most important risk factor for PMC [6][7][8]. This risk is at its peak within the first month after antibiotic use [9].Immediate diagnosis and treatment of this condition can decre...

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“…Overall, pseudomembranes have been detected in 41% of cases of CDAD [45] . Distal involvement of the colon is most common, making flexible sigmoidoscopy a reasonable initial test although in one series, false negative rate due to proximal involvement with rectal sparing was reported in 10% of cases [46] . Histologically, the pseudomembranes, composed of fibrin, mucus, epithelial and inflammatory cells appear as "clouds" rising from points of superficial ulcerations.…”

Section: Endoscopic Diagnosis Of CDImentioning

confidence: 99%

Clinical update for the diagnosis and treatment ofClostridium difficileinfection

Oldfield

Johnson

2014

WJGPT

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Clostridium difficile infection (CDI) presents a rapidly evolving challenge in the battle against hospitalacquired infections. Recent advances in CDI diagnosis and management include rapid changes in diagnostic approach with the introduction of newer tests, such as detection of glutamate dehydrogenase in stool and polymerase chain reaction to detect the gene for toxin production, which will soon revolutionize the diagnostic approach to CDI. New medications and multiple medical society guidelines have introduced changing concepts in the definitions of severity of CDI and the choice of therapeutic agents, while rapid expansion of data on the efficacy of fecal microbiota transplantation heralds a revolutionary change in the management of patients suffering multiple relapses of CDI. Through a comprehensive review of current medical literature, this article aims to offer an intensive review of the current state of CDI diagnosis, discuss the strengths and limitations of available laboratory tests, compare both current and future treatments options and offer recommendations for best practice strategies.

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Therapy of Antibiotic-Associated Pseudomembranous Colitis

Cited by 40 publications

References 0 publications

Clostridium difficile-associated diarrhea in adults

Clostridium difficile-associated diarrhea in adults

Pseudomemberanous Colitis following Cesarean Delivery with Adjunctive Intracolonic Vancomycin

Clinical update for the diagnosis and treatment ofClostridium difficileinfection

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