title: Effect of Metronidazole in Infants with Bowel Habit Change: Irrelative to theClostridium difficileColonization.
abstract: OBJECTIVE
  Clinical symptoms associated withClostridium difficileinfection (CDI) can vary widely. Carrier state without apparent symptoms is relatively common during infancy. The objective of this study was to determine the association ofC. difficilecolonization with bowel habit change and the effect ofC. difficilecolonization treatment on restoration of normal bowel habit.
  
  
  METHODS
  Between 2006 and 2014, infants at 1 to 12 months of age with diarrhea for more than 2 weeks who did not improve with conservative care were recruited from Gachon University Gil Medical Center. Infants who were followed up for at least 7 days were included. The presence or absence ofC. difficilecolonization, effect of metronidazole, and other medical records were reviewed. To determine the association between CDI and bowel habit change, logistic regression analysis was used.
  
  
  RESULTS
  Of a total of 126 infants, 74 (58.7%) were male patients. Of the 126 patients, 27 (21.4%) hadC. difficilecolonization. Significant (p<0.05) risk factors forC. difficilecolonization included artificial milk feeding (odds ratio [OR], 4.310; 95% confidence interval [CI], 1.564-11.878), prior rotavirus vaccination (OR, 4.322; 95% CI, 1.018-18.349), and antibiotic use (OR, 4.798; 95% CI, 1.430-16.101). There was improvement in bowel habit after metronidazole therapy (OR, 0.34; 95% CI, 0.15-0.79;p<0.05), regardless of the presence or absence ofC. difficilecolonization.
  
  
  CONCLUSIONS
  There was no significant correlation between bowel habit change andC. difficilecolonization during infancy. However, metronidazole can be used as an optional method to manage functional gastrointestinal disorders.
authors.affiliation: Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Eun Jin
authors.initials: EJ
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Sung Hyun
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Hann
authors.initials: H
authors.lastname: Tchah
authors.affiliation: Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Eell
authors.initials: E
authors.lastname: Ryoo
keywords: Clostridium difficile; Gastrointestinal diseases; Infant; Metronidazole