title: Efficacy of a diagnostic and therapeutic algorithm for Clostridium difficile infection.
abstract: In July 2012, metronidazole was approved for the treatment of Clostridium difficile infection (CDI). To clarify the selection criteria for the drug in terms of CDI severity, we established a diagnostic and therapeutic algorithm with reference to the SHEA-IDSA Clinical Practice Guidelines. We compared patients whose treatments were guided by the algorithm (29 cases, October 2012-September 2013) with patients treated prior to the development of the algorithm (37 cases, October 2011-September 2012). All cases treated with reference to the algorithm were diagnosed using enzyme immunoassay of C. difficile toxins A and B and glutamate dehydrogenase;an appropriate drug was prescribed in 93.1% of the cases. We found no significant between-group differences in the cure, recurrence, or complication rates. However, drug costs in cases wherein treatments were guided by the algorithm were markedly reduced. We have, thus, shown that algorithm-guided treatment is efficacious and cost-effective.
authors: Department of Gastroenterology, Marukawa Hospital, Medical Corporation COSMOS.
authors: Yohei
authors: Y
authors: Marukawa
authors: Takuya
authors: T
authors: Komura
authors: Takashi
authors: T
authors: Kagaya
authors: Hajime
authors: H
authors: Ohta
authors: Masashi
authors: M
authors: Unoura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents