title: Incidence and Clinical Outcomes of Clostridium difficile Infection after Treatment with Tuberculosis Medication.
abstract: OBJECTIVE
  To determine the incidence and clinical characteristics of tuberculosis (TB) medication-associated Clostridium difficile infection.
  
  
  METHODS
  This multicenter study included patients from eight tertiary hospitals enrolled from 2008 to 2013. A retrospective analysis was conducted to identify the clinical features of C. difficile infection in patients who received TB medication.
  
  
  RESULTS
  C. difficile infection developed in 54 of the 19,080 patients prescribed TB medication, representing a total incidence of infection of 2.83 cases per 1,000 adults. Fifty-one of the 54 patients (94.4%) were treated with rifampin. The patients were usually treated with oral metronidazole, which produced improvement in 47 of the 54 patients (87%). Twenty-three patients clinically improved with continuous rifampin therapy for C. difficile infection. There were no significant differences in improvement between patients treated continuously (n=21) and patients in whom treatment was discontinued (n=26).
  
  
  CONCLUSIONS
  The incidence of C. difficile infection after TB medication was not low considering the relatively low TB medication dosage compared to other antibiotics. It may not be always necessary to discontinue TB medication. Instead, decisions concerning discontinuation of TB medication should be based on TB status.
authors.affiliation: Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Yu Mi
authors.initials: YM
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Kyu Chan
authors.initials: KC
authors.lastname: Huh
authors.affiliation: Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Soon Man
authors.initials: SM
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Byung Ik
authors.initials: BI
authors.lastname: Jang
authors.affiliation: Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Jeong Eun
authors.initials: JE
authors.lastname: Shin
authors.affiliation: Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Hoon Sup
authors.initials: HS
authors.lastname: Koo
authors.affiliation: Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.
authors.forename: Yunho
authors.initials: Y
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Eulji University Hospital, Daejeon, Korea.
authors.forename: Sae Hee
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Hee Seok
authors.initials: HS
authors.lastname: Moon
authors.affiliation: Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Daejeon, Korea.
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000904:Antibiotics, Antitubercular / Q000009:adverse effects*; D016360:Clostridioides difficile; D004761:Enterocolitis, Pseudomembranous / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D012293:Rifampin / Q000009:adverse effects*; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy*
chemical_list: D000890:Anti-Infective Agents; D000904:Antibiotics, Antitubercular; D008795:Metronidazole; D012293:Rifampin
keywords: Clostridium difficile; Enterocolitis, pseudomembranous; Rifampin; Tuberculosis