Potential impact of removing metronidazole from treatment armamentarium of mild acute Clostridioides difficile infection
| Autor: | Bethlehem Mengesha, Shani Zilberman-Itskovich, Marina Bondarenco, Limor Toledano, Dror Marchaim, Ilan Youngster, Yael Kachlon, Ronit Zaidenstein, Nathan Strul, Tsilia Lazarovitch |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Potential impact medicine.medical_specialty genetic structures business.industry 030106 microbiology Retrospective cohort study biochemical phenomena metabolism and nutrition Clostridium difficile Microbiology 03 medical and health sciences Metronidazole Diarrhea 0302 clinical medicine Internal medicine medicine Antimicrobial stewardship Vancomycin 030212 general & internal medicine medicine.symptom business Clostridioides medicine.drug |
| Zdroj: | Future Microbiology. 14:1489-1495 |
| ISSN: | 1746-0921 1746-0913 |
| DOI: | 10.2217/fmb-2019-0157 |
| Popis: | Aim: Recent guidelines recommended removing metronidazole as a therapeutic option for Clostridioides difficile infections (CDI). However, superiority of vancomycin over metronidazole in mild CDI is not established and use of vancomycin might lead to emergence of vancomycin-resistant enterococci (VRE). Patients & methods: A retrospective cohort study and efficacy analyses were conducted at Shamir Medical Center, Israel (2010–2015), among adults with acute CDI. Results: A total of 409 patients were enrolled. In multivariable analyses, metronidazole was noninferior to vancomycin for mild CDI, but vancomycin was an independent predictor for post-CDI VRE acquisition. Conclusion: A significant independent association was evident between treatment with vancomycin and, later, acquisition of VRE. In first episodes of mild acute CDI, metronidazole should be considered a valid therapeutic option. |
| Databáze: | OpenAIRE |
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