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Effect of Metronidazole in Infants with Bowel Habit Change: Irrelative to the Clostridium difficile Colonization
Eun Jin Kim1, Sung Hyun Lee1, Hann Tchah1
1Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea.
Insights
Clostridium difficile colonization in infants does not significantly correlate with changes in bowel habits. However, metronidazole treatment may help manage functional gastrointestinal disorders in infants.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Infant Clostridium difficile infection (CDI) presents with varied symptoms, including asymptomatic colonization.
- Understanding the link between C. difficile colonization and bowel habit changes in infants is crucial for effective management.
Purpose of the Study:
- To investigate the association between C. difficile colonization and altered bowel habits in infants.
- To evaluate the efficacy of C. difficile colonization treatment in restoring normal bowel function.
Main Methods:
- A cohort of 126 infants (1-12 months) with persistent diarrhea was studied.
- Logistic regression analysis assessed the correlation between C. difficile colonization and bowel habit changes.
- The impact of metronidazole therapy on bowel habits was reviewed.
Main Results:
- 21.4% of infants exhibited C. difficile colonization.
- Risk factors for colonization included artificial milk feeding, rotavirus vaccination, and prior antibiotic use.
- Metronidazole therapy improved bowel habits, irrespective of C. difficile colonization status.
Conclusions:
- No significant association was found between C. difficile colonization and bowel habit changes in infants.
- Metronidazole serves as a potential therapeutic option for managing functional gastrointestinal disorders in this age group.
Purpose:
Clinical symptoms associated with Clostridium difficile infection (CDI) can vary widely. Carrier state without apparent symptoms is relatively common during infancy. The objective of this study was to determine the association of C. difficile colonization with bowel habit change and the effect of C. difficile colonization treatment on restoration of normal bowel habit.
Methods:
Between 2006 and 2014, infants at 1 to 12 months of age with diarrhea for more than 2 weeks who did not improve with conservative care were recruited from Gachon University Gil Medical Center. Infants who were followed up for at least 7 days were included. The presence or absence of C. difficile colonization, effect of metronidazole, and other medical records were reviewed. To determine the association between CDI and bowel habit change, logistic regression analysis was used.
Results:
Of a total of 126 infants, 74 (58.7%) were male patients. Of the 126 patients, 27 (21.4%) had C. difficile colonization. Significant (p<0.05) risk factors for C. difficile colonization included artificial milk feeding (odds ratio [OR], 4.310; 95% confidence interval [CI], 1.564-11.878), prior rotavirus vaccination (OR, 4.322; 95% CI, 1.018-18.349), and antibiotic use (OR, 4.798; 95% CI, 1.430-16.101). There was improvement in bowel habit after metronidazole therapy (OR, 0.34; 95% CI, 0.15-0.79; p<0.05), regardless of the presence or absence of C. difficile colonization.
Conclusion:
There was no significant correlation between bowel habit change and C. difficile colonization during infancy. However, metronidazole can be used as an optional method to manage functional gastrointestinal disorders.