Journal Article10.1001/JAMA.1993.03500010081036
Diagnosis and Treatment of Clostridium difficile Colitis
Robert Fekety,Akshay B. Shah +1 more
TL;DR: In patients with recurrent or relapsing colitis, treatment with either metronidazole or vancomycin is effective for that episode, but novel approaches, such as the oral or rectal introduction of competing nonpathogenic organisms, may prove to be more successful in prevention of relapses.
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Abstract: Pseudomembranous colitis associated with antibiotic therapy is almost always due to an overgrowth ofClostridium difficile. If untreated, pseudomembranous colitis can lead to severe diarrhea, hypovolemic shock, toxic dilatation of the colon, cecal perforation, hemorrhage, and death. However,C difficile— associated colitis can mimic the more common "benign" antibiotic-associated diarrhea that is not caused byC difficile. An algorithm for diagnosis management of hospitalized patients with antibiotic diarrhea andC difficilecolitis is presented in this review. Diagnosis depends on sigmoidoscopy and/or stool tests forC difficiletoxins in all patients with antibiotic-associated diarrhea. If the results of these tests are positive, either metronidazole or vancomycin is recommended for treatment of mild illness, and vancomycin is recommended for treatment of severe illness. Oral therapy is always preferred because it is more reliable. In patients with recurrent or relapsing colitis, treatment with either metronidazole or vancomycin is effective for that episode, but novel approaches, such as the oral or rectal introduction of competing nonpathogenic organisms, may prove to be more successful in prevention of relapses. (JAMA. 1993;269:71-75)
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References
Nosocomial acquisition of Clostridium difficile infection
TL;DR: Nosocomial C. difficile infection, which was associated with diarrhea in about one third of cases, is frequently transmitted among hospitalized patients and that the organism is often present on the hands of hospital personnel caring for such patients.
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Selective and differential medium for isolation of Clostridium difficile.
TL;DR: A selective and differential agar medium that contains cycloserine, cefoxitin, fructose, and egg yolk (CCFA) was developed to facilitate the isolation of C. difficile from fecal specimens and was found to be the most sensitive and selective of these media for the recovery of the bacterium.
Bacteriotherapy for chronic relapsing Clostridium difficile diarrhoea in six patients.
M. Tvede,Jørgen Rask-Madsen +1 more
TL;DR: Six patients with chronic relapsing diarrhoea caused by Clostridium difficile were treated with rectal instillation of homologous faeces or a mixture of ten different facultatively aerobic and anaerobic bacteria diluted in sterile saline, which led to a prompt loss of Cl Difficile and its toxin from the stools and to bowel colonisation by Bacteroides sp, which had not been present in pre-treatment stool samples.
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Prospective, controlled study of vinyl glove use to interrupt Clostridium difficile nosocomial transmission.
Stuart Johnson,Stuart Johnson,Dale N. Gerding,Dale N. Gerding,Mary M. Olson,Mary M. Olson,Mary D. Weiler,Mary D. Weiler,Rita A. Hughes,Rita A. Hughes,Connie Clabots,Connie Clabots,Lance R. Peterson,Lance R. Peterson +13 more
TL;DR: Vinyl glove use was associated with a reduced incidence of C.difficile diarrhea and is indirect evidence for hand carriage as a means of nosocomial C. difficile spread.
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•Journal Article
Treatment of recurrent Clostridium difficile colitis with vancomycin and Saccharomyces boulardii.
TL;DR: Saccharomyces boulardii, a nonpathogenic yeast, was found to be effective in preventing clindamycin cecitis recurrence in an animal model and may have a role in treating recurrent C. difficile diarrhea and colitis.
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