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Related Experiment Videos

Pseudomembranous colitis: causes and cures.

C M Surawicz1, L V McFarland

  • 1University of Washington, Seattle, Wash., USA. surawicz@u.washington.edu

Digestion
|March 30, 1999
PubMed
Summary
This summary is machine-generated.

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Pseudomembranous colitis (PMC) is a severe gastrointestinal infection caused by Clostridium difficile. Metronidazole is the first-line treatment, with vancomycin reserved for specific cases, and Saccharomyces boulardii may reduce recurrence.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Microbiology

Background:

  • Clostridium difficile is a leading cause of nosocomial gastrointestinal infections, with increasing incidence.
  • Symptoms range from diarrhea to severe colitis, with Pseudomembranous colitis (PMC) representing the most severe form.
  • PMC results from an intense inflammatory response to C. difficile toxins.

Purpose of the Study:

  • This review focuses on Pseudomembranous colitis (PMC), a severe manifestation of Clostridium difficile infection.
  • To outline diagnostic methods and recommended therapeutic strategies for PMC.
  • To discuss strategies for managing recurrent infections and preventing transmission.

Main Methods:

  • Diagnosis involves detecting Clostridium difficile in stool samples via culture, cytotoxin B assay, or rapid antigen immunoassays.

Related Experiment Videos

  • First-line oral therapy recommended is metronidazole (250 mg 4 times daily for 10 days).
  • Vancomycin is an alternative but its use should be restricted to minimize resistance development.

    • Main Results:

    • Therapeutic response to metronidazole is typically observed within a few days.
    • Recurrence of symptoms occurs in approximately 20% of cases, often linked to persistent C. difficile.
    • Pulsed or tapered antibiotic regimens and normalization of fecal flora can be effective for recurrent cases.

    Conclusions:

    • Metronidazole is the primary treatment for PMC, with vancomycin reserved for specific indications.
    • Managing recurrent C. difficile infections may involve altered antibiotic regimens or adjunctive therapies like Saccharomyces boulardii.
    • Preventing epidemics requires stringent hygiene measures, including hand washing and environmental decontamination.