Related Experiment Video

Updated: Aug 4, 2025

A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
12:58

A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment

Published on: May 25, 2017

9.1K

Optimal therapeutic recommendation for Clostridioides difficile infection in pediatric and adolescent populations: a

Sho Tashiro1, Takayuki Mihara1, Rikiya Okawa1

  • 1Division of Pharmacodynamics, Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo, 105-8512, Japan.

European Journal of Pediatrics
|March 31, 2023
PubMed

Insights

Metronidazole (MNZ) showed lower cure rates than vancomycin (VCM) for pediatric Clostridioides difficile infection (CDI) in the US and Europe. Recurrence rates were similar, making MNZ not recommended for pediatric CDI management.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Pediatric Medicine

Background:

  • Clostridioides difficile infection (CDI) management in pediatric and adolescent populations lacks robust therapeutic agent recommendations.
  • Choosing effective antibiotics for pediatric CDI is challenging due to limited data.

Approach:

  • A systematic review and meta-analysis was performed using data from four major electronic databases.
  • Efficacy of metronidazole (MNZ) and vancomycin (VCM) for pediatric CDI was assessed by analyzing clinical cure and recurrence rates.
  • Subgroup analyses were conducted by region to address geographical variations in CDI treatment outcomes.

Key Points:

  • Overall clinical cure rates for MNZ and VCM in pediatric CDI patients were not significantly different.
  • However, MNZ demonstrated significantly lower clinical cure rates compared to VCM in the United States and Europe.
  • No significant difference in recurrence rates was observed between MNZ and VCM treatments.

Conclusions:

  • Metronidazole is not recommended for managing Clostridioides difficile infection in pediatric and adolescent patients, particularly in the USA and Europe.
  • Vancomycin shows superior clinical cure rates in these specific regions for pediatric CDI.
  • Further research may explore regional treatment guidelines and antibiotic efficacy in pediatric CDI.

Keywords:
Clostridioides difficile infectionMetronidazolePediatric and adolescent populationsSystematic review and meta-analysisVancomycin

More Related Videos

Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R2029106:51

Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R20291

Published on: December 10, 2016

12.6K
Culturing and Maintaining Clostridium difficile in an Anaerobic Environment11:13

Culturing and Maintaining Clostridium difficile in an Anaerobic Environment

Published on: September 14, 2013

38.9K

Related Concept Videos

Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents01:18

Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents

Acute diarrhea, a common gastrointestinal disturbance, is characterized by the rapid evacuation of fluid stools, leading to an excessive weight in fluid. This condition typically arises from disorders affecting intestinal water and electrolyte transport. It can be triggered by an increased osmotic load within the intestine, excessive secretion of electrolytes and water, mucosal exudation of protein and fluid, or altered intestinal motility. The primary risks of acute diarrhea are dehydration...
174
Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy01:16

Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy

Helicobacter pylori, a resilient gram-negative bacterium, can thrive in the stomach's harsh, acidic environment. Infection with H. pylori leads to a cascade of events within the stomach lining. One of the critical disruptions caused by this bacterium is the interference with somatostatin production, a hormone responsible for regulating acid secretion. This interference tips the balance, escalating acid secretion and diminishing bicarbonate levels. This imbalance compromises the defensive...
479
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
165
Drugs for Treatment of Diarrhea-Predominant IBS01:17

Drugs for Treatment of Diarrhea-Predominant IBS

Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
238
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
166
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
212