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Sponsors and Collaborators: |
VA Medical Center, Houston Baylor College of Medicine |
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Information provided by: | VA Medical Center, Houston |
ClinicalTrials.gov Identifier: | NCT00304369 |
In this record review study, our objective is to determine the rates of cure, failure and relapse following treatment of C. difficile colitis with metronidazole.
Condition | Intervention |
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Clostridium Enterocolitis Pseudomembranous Colitis Antibiotic-Associated Colitis |
Drug: Metronidazole |
Study Type: | Observational |
Official Title: | The Response of Clostridium Difficile Infection to Metronidazole Therapy |
Estimated Enrollment: | 290 |
Clostridium difficile is a major cause of nosocomial infection. When this organism proliferates in the colon, usually as a result of prior antibiotic therapy in a hospitalized or otherwise debilitated person, a variety of potentially serious consequences follow, such as fever, leukocytosis, abdominal pain, diarrhea and ileus. Some patients require surgical exploration and colectomy, and our hospital has had several deaths attributable to C.
difficile colitis in the past year.
C. difficile colitis is treated with metronidazole, and earlier literature on this subject, written in the 1980's and early 1990s, suggests that the response rate is excellent, exceeding 90-95%. Our clinical observation has suggested that treatment with metronidazole is followed by a surprisingly high rate of failure, perhaps 25-30%.
The clinical problem is that there are, at present, no desirable alternatives. Vancomycin, given orally, is said to be highly effective in treating this infection, but this may not be true, and the administration of this drug is associated with emergence of vancomycin-resistant bacteria, a major problem in modern hospitals. No other drug is approved for treatment of C. difficile infection.
We believe it is important to determine the actual rate of failure of treatment with metronidazole. This will provide an impetus for developing new therapeutic approaches.
We will review the records of patients who have been treated for confirmed C. difficile infection with metronidazole at the VAMC for the past 12 months in order to determine the rates of cure, failure, and relapse following therapy. This is a simple record review study to determine if our clinical suspicion is correct, namely, if the rate of failure of metronidazole therapy is much higher than that reported in the medical literature of 10-15 years ago.
Ages Eligible for Study: | 18 Years to 64 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
difficile colitis with oral metronidazole will be included in this study.
Exclusion Criteria:
Contact: Daniel M Musher, M.D. | 713-794-7384 | dmusher@bcm.tmc.edu |
Contact: Nancy L Logan, M.D. | 713-794-7384 | njarrar@bcm.tmc.edu |
United States, Texas | |
Michael E. Debakey VA Medical Center | Recruiting |
Houston, Texas, United States, 77030 | |
Contact: Daniel M Musher, MD 713-794-7384 dmusher@bcm.tmc.edu | |
Principal Investigator: Daniel M Musher, M.D. |
Principal Investigator: | Daniel M Musher, M.D. | Houston VA Medical Center |
Study ID Numbers: | H-16175 |
Study First Received: | March 16, 2006 |
Last Updated: | March 16, 2006 |
ClinicalTrials.gov Identifier: | NCT00304369 History of Changes |
Health Authority: | United States: Institutional Review Board |
Clostridium difficile |
Bacterial Infections Anti-Infective Agents Metronidazole Gastrointestinal Diseases Colonic Diseases Enterocolitis, Pseudomembranous Clostridium Difficile Intestinal Diseases |
Enterocolitis Gram-Positive Bacterial Infections Digestive System Diseases Radiation-Sensitizing Agents Clostridium Infections Gastroenteritis Colitis |
Bacterial Infections Anti-Infective Agents Metronidazole Antiprotozoal Agents Gastrointestinal Diseases Physiological Effects of Drugs Colonic Diseases Enterocolitis, Pseudomembranous Intestinal Diseases Enterocolitis |
Pharmacologic Actions Antiparasitic Agents Gram-Positive Bacterial Infections Digestive System Diseases Radiation-Sensitizing Agents Therapeutic Uses Clostridium Infections Gastroenteritis Colitis |