Journal Article

Relatively Poor Outcome after Treatment of <i>Clostridium difficile</i> Colitis with Metronidazole

Daniel M. Musher, Saima Aslam, Nancy Logan, Srikanth Nallacheru, Imran Bhaila, Franziska Borchert and Richard J. Hamill

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 40, issue 11, pages 1586-1590
Published in print June 2005 | ISSN: 1058-4838
Published online June 2005 | e-ISSN: 1537-6591 | DOI:
Relatively Poor Outcome after Treatment of Clostridium difficile Colitis with Metronidazole

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Clostridium difficile is a frequent cause of serious nosocomial infection. Earlier reports have suggested that treatment with metronidazole cured nearly 90% of patients, with only a modest rate of recurrence of infection. In recent years, the rate of response to treatment with this drug has appeared to be much lower.


We undertook a prospective, observational study of 207 patients who were treated with metronidazole for C. difficile colitis.


A total of 103 patients (50%) were cured by the initial course of therapy and had no recurrence of disease. Forty-six patients (22%) continued to have symptoms of colitis for ⩾10 days despite treatment, and 58 (28%) responded initially but had a recurrence within the ensuing 90 days. The mortality rate among patients who developed C. difficile colitis was 27%, and it was higher among patients who did not respond fully to an initial course of therapy, compared with those who did (33% vs. 21%; P < .05).


Because of the relatively poor response to therapy, additional approaches to prevention and/or treatment of C. difficile colitis appear to be warranted.

Journal Article.  3663 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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