Duration and Recurrence Rate of Vancomycin Powder, Metronidazole Tablets and Injections in the Treatment of Clostridium Difficile Associated Diarrhea

Abstract

Clostridium difficile (C. difficile) is a major causative bacterium of diarrhea that occurs concurrently after the administration of antibiotics (antibiotic associated diarrhea). Vancomycin (VCM) and metronidazole (MNZ) are used as therapeutic agents for C. difficile associated diarrhea (CDAD). In the C. difficile therapy guideline, the administration period of VCM and MNZ is defined as 10 to 14 days. However, because there were cases where medication treatment was discontinued within the administration period of less than 10 days, the symptoms improved early. Therefore, we investigated the relationship between the administration period of VCM or MNZ and the recurrence rate of CDAD. As a result, the recurrence rate of CDAD tended to be higher in the case where the treatment period was less than 10 days, and in the case where the number of doses per day was less than 4. This suggests the importance of intervention by pharmacists on the administration period and the number of administrations of VCM and MNZ in the treatment of CDAD.