Recurrent Clostridium difficile disease: epidemiology and clinical characteristics.
Infect Control Hosp Epidemiol
; 20(1): 43-50, 1999 Jan.
Article
em En
| MEDLINE
| ID: mdl-9927265
ABSTRACT
OBJECTIVE:
To describe the epidemiology, diagnosis, risk factors, patient impact, and treatment strategies for recurrent Clostridium difficile-associated disease (CDAD).DESIGN:
Data were collected as part of a blinded, placebo-controlled clinical trial testing a new combination treatment for recurrent CDAD. Retrospective data regarding prior CDAD episodes were collected from interviews and medical-chart review. Prospective data on the current CDAD episode, risk factors, and recurrence rates were collected during a 2-month follow-up. SETTINGS National referral study.PARTICIPANTS:
Patients with recurrent CDAD.INTERVENTIONS:
Treatment with a 10-day course of low-dose (500 mg/d) or high-dose (2 g/d) vancomycin or metronidazole (1 g/d).RESULTS:
Recurrent CDAD was found to have a lengthy course involving multiple episodes of diarrhea, abdominal cramping, nausea, and fever. CDAD may recur over several years despite frequent treatment with antibiotics. Recurrence rates were similar regardless of the choice or dose of antibiotic. Recurrent CDAD is not a trivial disease patients may have multiple episodes (as many as 14), may require hospitalization, and the mean lifetime cost of direct medical care was $10,970 per patient. Fortunately, the disease does not become progressively more severe as the number of episodes increase. Two risk factors predictive for recurrent CDAD were found increasing age and a decreased quality-of-life score at enrollment.CONCLUSIONS:
Recurrent CDAD is a persistent disease that may result in prolonged hospital stays, additional medical costs, and rare serious complications.
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Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
/
3_ND
Base de dados:
MEDLINE
Assunto principal:
Enterocolite Pseudomembranosa
/
Clostridioides difficile
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Aspecto:
Patient_preference
Limite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Infect Control Hosp Epidemiol
Ano de publicação:
1999
Tipo de documento:
Article