Potential impact of removing metronidazole from treatment armamentarium of mild acute Clostridioides difficile infection.

Abstract:

:Aim: Recent guidelines recommended removing metronidazole as a therapeutic option for Clostridioides difficile infections (CDI). However, superiority of vancomycin over metronidazole in mild CDI is not established and use of vancomycin might lead to emergence of vancomycin-resistant enterococci (VRE). Patients & methods: A retrospective cohort study and efficacy analyses were conducted at Shamir Medical Center, Israel (2010-2015), among adults with acute CDI. Results: A total of 409 patients were enrolled. In multivariable analyses, metronidazole was noninferior to vancomycin for mild CDI, but vancomycin was an independent predictor for post-CDI VRE acquisition. Conclusion: A significant independent association was evident between treatment with vancomycin and, later, acquisition of VRE. In first episodes of mild acute CDI, metronidazole should be considered a valid therapeutic option.

journal_name

Future Microbiol

journal_title

Future microbiology

authors

Zilberman-Itskovich S,Youngster I,Lazarovitch T,Bondarenco M,Toledano L,Kachlon Y,Mengesha B,Strul N,Zaidenstein R,Marchaim D

doi

10.2217/fmb-2019-0157

subject

Has Abstract

pub_date

2019-11-01 00:00:00

pages

1489-1495

eissn

1746-0913

issn

1746-0921

journal_volume

14

pub_type

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