Vancomycin and Metronidazole for the Treatment of Clostridium difficile--Associated Diarrhea

Bishara, Jihad; Wattad, Morad

doi:10.1086/523720

Cited by 7 publications

(8 citation statements)

References 14 publications

(6 reference statements)

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“…We caution readers not to over-interpret the combined analysis presented by Bishara et al [1]. In contrast with our trial, the studies by Teasley et al [10] and Wenisch et al [11] were neither placebo-controlled nor blinded.…”

contrasting

confidence: 58%

“…To the Editor-We appreciate the insightful comments found in 3 letters [1][2][3] published in this issue of Clinical Infectious Diseases regarding our recently published article [4]. We agree with the concerns that isolated Clostridium difficile toxin A positivity may not be a relevant outcome in the absence of our other clinical end points of diarrhea, colectomy, and/or death.…”

mentioning

confidence: 62%

“…To the Editor-We would like to comment on the article by Yu et al [1] regarding the risk factors for nosocomial outbreaks of severe acute respiratory syndrome that occurred in some hospital wards and not in others. The authors performed a retrospective case-control study at the ward level and found that several environmental or administrative factors and host factors, such as oxygen therapy or bilevel positive airway pressure ventilation, were associated with the occurrence of these outbreaks.…”

Section: Nosocomial Transmission Of Severe Acute Respiratory Syndromementioning

confidence: 99%

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Reply to Bishara et al., Huggan et al., and Lawrence et al

Zar

Davis

2007

Clinical Infectious Diseases

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contrasting

confidence: 58%

mentioning

confidence: 62%

Section: Nosocomial Transmission Of Severe Acute Respiratory Syndromementioning

confidence: 99%

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Reply to Bishara et al., Huggan et al., and Lawrence et al

Zar

Davis

2007

Clinical Infectious Diseases

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“…A potential explanation of these observations is that vancomycin is significantly more effective than metronidazole at inducing bacteriologic cure among RCDI patients 22 . Even so, the apparent clinical benefit of vancomycin may be offset by its high cost and deleterious effects on commensal gram-positive gut microflora (which may, notably, contribute to further recurrence) 106 and concerns about VRE resistance 115 . The significance of such concerns will remain ambiguous without further randomized controlled trials.…”

Section: Current Managementmentioning

confidence: 99%

Recurrent Clostridium difficile infection: From colonization to cure

et al. 2015

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Clostridium difficile infection (CDI) is increasingly prevalent, dangerous and challenging to prevent and manage. Despite intense national and international attention the incidence of primary and of recurrent CDI (PCDI and RCDI, respectively) have risen rapidly throughout the past decade. Of major concern is the increase in cases of RCDI resulting in substantial morbidity, morality and economic burden. RCDI management remains challenging as there is no uniformly effective therapy, no firm consensus on optimal treatment, and reliable data regarding RCDI-specific treatment options is scant. Novel therapeutic strategies are critically needed to rapidly, accurately, and effectively identify and treat patients with, or at-risk for, RCDI. In this review we consider the factors implicated in the epidemiology, pathogenesis and clinical presentation of RCDI, evaluate current management options for RCDI and explore novel and emerging therapies.

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“…Critiques of the Zar et al [102] article were that one of the criteria for failure was persistent toxin positivity at day 6 and 10 of therapy. In addition, there was exclusion of 8 patients with early death [103] . When the 2 patients who were judged as having failed therapy solely on the basis of persistent toxin positivity and the 8 early deaths were included, vancomycin was still superior to metronidazole for those with severe disease with a 90% cure rate for vancomycin vs 71% for metronidazole (P = 0.04).…”

Section: Treatment Decisions Based Upon Stratification By Disease Sevmentioning

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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Vancomycin and Metronidazole for the Treatment of Clostridium difficile--Associated Diarrhea

Cited by 7 publications

References 14 publications

Reply to Bishara et al., Huggan et al., and Lawrence et al

Reply to Bishara et al., Huggan et al., and Lawrence et al

Recurrent Clostridium difficile infection: From colonization to cure

Clinical update for the diagnosis and treatment ofClostridium difficileinfection

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