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Drug-induced Clostridium difficile-associated disease

M L Job1, N F Jacobs

  • 1Department of Pharmacy Practice, Mercer University, School of Pharmacy, Atlanta, Georgia, USA.

Drug Safety
|July 1, 1997
PubMed
Summary

Clostridium difficile-associated disease (CDAD) is a significant gastrointestinal illness often triggered by antibacterial use. Prompt diagnosis and appropriate treatment, including antibacterial discontinuation or specific therapies like metronidazole and vancomycin, are crucial for patient recovery.

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Area of Science:

  • Microbiology
  • Gastroenterology
  • Infectious Diseases

Background:

  • Clostridium difficile is a spore-forming anaerobe causing gastrointestinal disease.
  • Antibacterial and antineoplastic agents can promote C. difficile overgrowth and toxin release.
  • Colonization rates are higher in infants and hospitalized individuals.

Purpose of the Study:

  • To review the factors contributing to Clostridium difficile-associated disease (CDAD).
  • To discuss the spectrum of illness, incidence, and treatment options for CDAD.
  • To highlight the importance of prevention strategies for CDAD.

Main Methods:

  • Literature review of studies on Clostridium difficile and CDAD.
  • Analysis of risk factors, clinical manifestations, and therapeutic interventions.

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  • Examination of epidemiological data and prevention measures.

    • Main Results:

    • Certain antibacterials (aminopenicillins, cephalosporins, clindamycin) are high-risk agents for CDAD.
    • CDAD spectrum ranges from mild diarrhea to severe colitis, toxic megacolon, and sepsis.
    • Metronidazole and vancomycin are effective for moderate to severe CDAD; vancomycin use is limited by resistance.

    Conclusions:

    • Discontinuation of offending antibacterials is key for mild CDAD.
    • Appropriate antibacterial selection and infection control are vital for CDAD prevention.
    • Recurrent CDAD may respond to initial treatment regimens.