The DOI matches its Crossref record; 22 of the 22 references it cites were found in a registry or an index.
Diagnosis and Treatment of Clostridium difficile Colitis
Abstract
Pseudomembranous colitis associated with antibiotic therapy is almost always due to an overgrowth of Clostridium difficile. If untreated, pseudomembranous colitis can lead to severe diarrhea, hypovolemic shock, toxic dilatation of the colon, cecal perforation, hemorrhage, and death. However, C difficile-associated colitis can mimic the more common "benign" antibiotic-associated diarrhea that is not caused by C difficile. An algorithm for diagnosis management of hospitalized patients with antibiotic diarrhea and C difficile colitis is presented in this review. Diagnosis depends on sigmoidoscopy and/or stool tests for C difficile toxins in all patients with antibiotic-associated diarrhea. If the results of these tests are positive, either metronidazole or vancomycin is recommended for treatment of mild illness, and vancomycin is recommended for treatment of severe illness. Oral therapy is always preferred because it is more reliable. In patients with recurrent or relapsing colitis, treatment with either metronidazole or vancomycin is effective for that episode, but novel approaches, such as the oral or rectal introduction of competing nonpathogenic organisms, may prove to be more successful in prevention of relapses.
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Cites
Nosocomial Acquisition of Clostridium difficile Infection
McFarland, L. V., Mulligan, M. E., Kwok, R. Y. Y., & Stamm, W. E. (1989) · New England Journal of Medicine · doi:10.1056/nejm198901263200402 · Cited by 1,326
Selective and differential medium for isolation of Clostridium difficile
George, W. L., Sutter, V. L., Citron, D., & Finegold, S. M. (1979) · Journal of Clinical Microbiology · doi:10.1128/jcm.9.2.214-219.1979 · Cited by 632
Clostridium difficile: its disease and toxins
Lyerly, D. M., Krivan, H. C., & Wilkins, T. D. (1988) · Clinical Microbiology Reviews · doi:10.1128/cmr.1.1.1 · Cited by 576
Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: A prospective study
Surawicz, C. M., Elmer, G. W., Speelman, P., McFarland, L. V., Chinn, J., & Van Belle, G. (1989) · Gastroenterology · doi:10.1016/0016-5085(89)91613-2 · Cited by 573
BACTERIOTHERAPY FOR CHRONIC RELAPSING CLOSTRIDIUM DIFFICILE DIARRHOEA IN SIX PATIENTS
Tvede, M., & Rask-Madsen, J. (1989) · The Lancet · doi:10.1016/s0140-6736(89)92749-9 · Cited by 491
SUCCESSFUL TREATMENT OF RELAPSING CLOSTRIDIUM DIFFICILE COLITIS WITH LACTOBACILLUS GG
Gorbach, S., Chang, T.-W., & Goldin, B. (1987) · The Lancet · doi:10.1016/s0140-6736(87)92646-8 · Cited by 464
Johnson, S., Homann, S. R., Bettin, K. M., Quick, J. N., Clabots, C. R., Peterson, L. R., & Gerding, D. N. (1992) · Annals of Internal Medicine · doi:10.7326/0003-4819-117-4-297 · Cited by 355
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Self-citationApproach to patients with multiple relapses of antibiotic-associated pseudomembranous colitis.
Tedesco, F. J., Gordon, D., & Fortson, W. C. (1985) · PubMed · Cited by 217
Cited by
Clostridium Difficile-Associated Diarrhea and Colitis
Gerding, D. N., Johnson, S., Peterson, L. R., Mulligan, M. E., & Silva, J. (1995) · Infection Control & Hospital Epidemiology · doi:10.1086/648363 · Cited by 631
O’Grady, N. P., Barie, P. S., Bartlett, J. G., Bleck, T., Carroll, K., Kalil, A. C., Linden, P., Maki, D. G., Nierman, D., Pasculle, W., et al. (2008) · Critical Care Medicine · doi:10.1097/ccm.0b013e318169eda9 · Cited by 600
Narrative Review: The New Epidemic of Clostridium difficile–Associated Enteric Disease
Bartlett, J. G. (2006) · Annals of Internal Medicine · doi:10.7326/0003-4819-145-10-200611210-00008 · Cited by 599
Metronidazole: A Therapeutic Review and Update
Freeman, C. D., Klutman, N. E., & Lamp, K. C. (1997) · Drugs · doi:10.2165/00003495-199754050-00003 · Cited by 473
Clostridium difficile–Associated Diarrhea
Johnson, S., & Gerding, D. N. (1998) · Clinical Infectious Diseases · doi:10.1086/520276 · Cited by 441
Metadata
- Authors
- Fekety, R.
- Venue
- JAMA: The Journal of the American Medical Association
- Publisher
- American Medical Association (AMA)
- Published
- 1993-01-06
- Volume
- 269
- Issue
- 1
- Pages
- 71
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W1969791292
- Cited by
- 354
- References
- 22
- FWCI
- 14.54
- Type
- journal article
- Language
- en
- Open access
- closed
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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