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  • Title: Clostridium difficile-associated diarrhea: risk factors, diagnostic methods, and treatment.
    Author: Oldfield EC.
    Journal: Rev Gastroenterol Disord; 2004; 4(4):186-95. PubMed ID: 15580153.
    Abstract:
    Clostridium difficile-associated diarrhea (CDAD) has become the most common cause of infectious diarrhea acquired in the hospital, with an estimated 3 million annual cases and an annual cost of $1 billion. Risk factors for CDAD include antibiotic use (especially ampicillin, clindamycin, and cephalosporins), advanced age, and gastrointestinal surgery. Specific diagnosis of CDAD is made with an enzyme immunoassay to detect toxins A and B. Metronidazole remains the initial treatment of choice, with a 95% success rate. Vancomycin is reserved for failures. Despite the high initial success rates, recurrence of CDAD remains a significant problem in 20% to 30% of cases, with increased cost and substantial morbidity. Efforts to prevent CDAD will need to be strengthened, including education and better compliance with isolation, use of gloves, and hand washing.
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