Older age , use of antibiotics after diagnosis , use of proton pump inhibitors , and strain type were the most frequent risk factors for recurrence .
Older age , leucocytosis , renal failure and co-morbidities were frequent risk factors for complicated CDI .
When considered alone , mortality was associated with age , co-morbidities , hypo-albuminemia , leucocytosis , acute renal failure , and infection with ribotype 027 .
BACKGROUND Clostridium difficile infection ( CDI ) can lead to complications , recurrence , and death .
Numerous studies have assessed risk factors for these unfavourable outcomes , but systematic review s or meta-analyses published so far were limited in scope or in quality .
Treatment with monoclonal antibodies against Clostridium difficile toxins.
BACKGROUND New therapies are needed to manage the increasing incidence , severity , and high rate of recurrence of Clostridium difficile infection . METHODS We performed a r and omized , double-blind , placebo-controlled study of two neutralizing , fully human monoclonal antibodies against C. difficile toxins A ( CDA1 ) and B ( CDB1 ) . The antibodies were administered together as a single infusion , each at a dose of 10 mg per kilogram of body weight , in patients with symptomatic C. difficile infection who were receiving either metronidazole or vancomycin .  The primary outcome was laboratory-documented recurrence of infection during the 84 days after the administration of monoclonal antibodies or placebo . RESULTS Among the 200 patients who were enrolled ( 101 in the antibody group and 99 in the placebo group ) , the rate of recurrence of C. difficile infection was lower among patients treated with monoclonal antibodies ( 7 % vs. 25 % ; 95 % confidence interval , 7 to 29 ; P<0.001 ) . The recurrence rates among patients with the epidemic BI/NAP1/027 strain were 8 % for the antibody group and 32 % for the placebo group ( P=0.06 ) ; among patients with more than one previous episode of C. difficile infection , recurrence rates were 7 % and 38 % , respectively ( P=0.006 ) . The mean duration of the initial hospitalization for in patients did not differ significantly between the antibody and placebo groups ( 9.5 and 9.4 days , respectively ) . At least one serious adverse event was reported by 18 patients in the antibody group and by 28 patients in the placebo group ( P=0.09 ) . CONCLUSIONS The addition of monoclonal antibodies against C. difficile toxins to antibiotic agents significantly reduced the recurrence of C. difficile infection . ( Clinical Trials.gov number , NCT00350298 .
Older age , use of antibiotics after diagnosis , use of proton pump inhibitors , and strain type were the most frequent risk factors for recurrence .
Older age , leucocytosis , renal failure and co-morbidities were frequent risk factors for complicated CDI .
When considered alone , mortality was associated with age , co-morbidities , hypo-albuminemia , leucocytosis , acute renal failure , and infection with ribotype 027 .
BACKGROUND Clostridium difficile infection ( CDI ) can lead to complications , recurrence , and death .
Numerous studies have assessed risk factors for these unfavourable outcomes , but systematic review s or meta-analyses published so far were limited in scope or in quality .