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[Relapsing infections with Clostridium difficile].

W E Visser1, A M Dingemans-Dumas, D J Bac

  • 1Ikazia Ziekenhuis, Montessoriweg 1, 3083 AN Rotterdam. wevisser@hotmail.com

Nederlands Tijdschrift Voor Geneeskunde
|November 10, 2005
PubMed
Summary
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Recurrent Clostridioides difficile colitis, a common complication of antibiotic use, can be challenging. A pulse and tapering vancomycin regimen effectively treated relapsed C. difficile infections in elderly patients.

Area of Science:

  • Infectious Diseases
  • Gastroenterology
  • Microbiology

Background:

  • Antibiotic-associated diarrhea is frequently caused by Clostridioides difficile infection.
  • Diagnosis relies on clinical presentation, cytotoxin testing, immunoassay, and endoscopy.
  • Initial infections and first relapses are typically treated with metronidazole or vancomycin.

Observation:

  • Two elderly women (78 and 85 years) developed watery diarrhea and fever post-antibiotic therapy.
  • Both patients were diagnosed with pseudomembranous colitis, initially treated successfully.
  • Both patients experienced a relapse of C. difficile colitis.

Findings:

  • A pulse and tapering vancomycin regimen was successfully used to treat the relapsed C. difficile colitis.

Related Experiment Videos

  • This treatment approach demonstrates efficacy in managing recurrent C. difficile infections.
  • Multiple recurrences can still occur, posing treatment challenges.

    • Implications:

    • Effective management strategies are crucial for recurrent C. difficile infections.
    • Pulse and tapering vancomycin is a viable option for second relapses.
    • Further research may be needed for refractory or multiple recurrent cases.