Summary
Twenty courses of fusidic acid were given to 16 patients with antibiotic-associated colitis caused byClostridium difficile. Fusidic acid was given in a dose of 0.5–1.5 g daily for seven to 21 days. Diarrhoea disappeared rapidly. Clinical relapse occurred after five courses and once when the patient was still on treatment. Clinical cure with persistence or reappearance of toxin occurred in four further patients. Nineteen courses of metronidazole were given to 19 patients who experienced six failures or relapses. Seven courses of vancomycin were given to five patients, three of whom had had relapse. Five patients healed without treatment. The relapses occurred only in old and prostrated patients. They often recurred several times in the same patient. 0.5 g of fusidic acid daily appears to be as effective as vancomycin and metronidazole for the treatment ofC. difficile-induced colitis.
Zusammenfassung
Sechzehn Patienten mit Antibiotikaassoziierter Colitis durchClostridium difficile wurden in 20 Therapiezyklen mit Fusidinsäure behandelt. Die Behandlung mit Tagesdosen von 0,5–1,5 g dauerte sieben bis 21 Tage. Die Diarrhöe sistierte rasch. In fünf Fällen trat nach der Therapie ein Rezidiv auf, in einem Fall unter der Therapie. Bei weiteren vier Patienten kam es zur klinischen Heilung, während jedoch die Toxinausscheidung persistierte oder rezidivierte. Im gleichen Zeitraum wurden bei 19 Patienten 19 Therapiezyklen von Metronidazol verabreicht, dabei kam es in sechs Fällen zum Therapieversagen oder zu Rezidiven. Bei fünf Patienten, von denen drei einen Rückfall erlitten hatten, wurde in sieben Therapiezyklen Vancomycin verabreicht. Bei fünf Patienten trat ohne Medikamente eine Heilung ein.
Similar content being viewed by others
Literature
Silva, J. Jr., Batts. D. H., Fekety, F. R., Plouffe, J., Rifkin, G. D., Baird, I. Treatment ofClostridium difficile colitis and diarrhoea with vancomycin. Am. J. Med. 71 (1981) 815–821.
Bartlett, J. G., Tedesco, F. J., Shull, S., Lowe, B., Chang, T. Symptomatic relapse after oral vancomycin therapy of antibiotic-associated pseudomembranous colitis. Gastroenterology 78 (1980) 431–434.
Teasley, D. G., Gerding, D. N., Olson, M. M., Peterson, L. R., Gebhard, R. L., Schwartz, M. J., Lee, Jr., J. T. Prospective randomised trial of metronidazole versus vancomycin forClostridium difficile-associated diarrhoea and colitis. Lancet II (1983) 1043–1046.
Chang, T., Gorbach, S. L., Bartlett, J. G., Saginur, R. Bacitracin treatment of antibiotic-associated colitis and diarrhea caused byClostridium difficile toxin. Gastroenterology 78 (1980) 1584–1586.
Burdon, D. W., Brown, J. D., Youngs, D. J., Arabi, Y., Shinagawa, N., Alexander-Williams, J., Keighley, M. R. P., George, R. H. Antibiotic susceptibility ofClostridium difficile. J. Antimicrob. Chemother. 5 (1979) 307–310.
Möllby, R., Nord, C. E., Aronsson, B. Diagnosis ofC. difficile-associated enterocolitis in Sweden. Laboratory and epidemiological aspects. Scand. J. Infect. Dis. 22 Suppl. (1980) 30–36.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Cronberg, S., Castor, B. & Thorén, A. Fusidic acid for the treatment of antibiotic-associated colitis induced by clostridium difficile. Infection 12, 276–279 (1984). https://doi.org/10.1007/BF01645961
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01645961