title: Recurrent refractory Clostridium difficile colitis treated successfully with rifaximin and tigecycline: a case report and review of the literature.
abstract: Clostridium difficile colitis infection is on the rise and is considerably increasing the duration of hospital stay, as well as healthcare costs. The management of C. difficile colitis has become more challenging with the increasing failure of therapeutic response to metronidazole and oral vancomycin. Tigecycline is a new glycylcycline that has shown in vitro activity against C. difficile. We report herein a case of C. difficile colitis that failed to improve on a combination of metronidazole and oral vancomycin. The patient subsequently developed a surgical abdomen secondary to refractory C. difficile colitis, but was successfully treated with a combination of rifaximin and tigecycline after she refused to undergo surgical treatment.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon. herterima@hotmail.com
authors.forename: Rima I
authors.initials: RI
authors.lastname: El-Herte
authors.forename: Tania A
authors.initials: TA
authors.lastname: Baban
authors.forename: Souha S
authors.initials: SS
authors.lastname: Kanj
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000188:drug therapy* / Q000382:microbiology; D003092:Colitis / Q000188:drug therapy* / Q000382:microbiology*; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D006801:Humans; D008795:Metronidazole / Q000008:administration & dosage; D008911:Minocycline / Q000008:administration & dosage / Q000031:analogs & derivatives*; D012008:Recurrence; D012294:Rifamycins / Q000008:administration & dosage*; D000078262:Rifaximin; D000078304:Tigecycline; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage
chemical_list: D000900:Anti-Bacterial Agents; D012294:Rifamycins; D008795:Metronidazole; D014640:Vancomycin; D000078304:Tigecycline; D008911:Minocycline; D000078262:Rifaximin