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 .
Recurrent Clostridium difficile disease: epidemiology and clinical characteristics.
OBJECTIVE To describe the epidemiology , diagnosis , risk factors , patient impact , and treatment strategies for recurrent Clostridium difficile-associated disease ( CDAD ) . DESIGN Data were collected as part of a blinded , placebo-controlled clinical trial testing a new combination treatment for recurrent CDAD . Retrospective data regarding prior CDAD episodes were collected from interviews and medical-chart review . Prospect i ve data on the current CDAD episode , risk factors , and recurrence rates were collected during a 2-month follow-up . SETTING S National referral study . PARTICIPANTS Patients with recurrent CDAD . INTERVENTIONS Treatment with a 10-day course of low-dose ( 500 mg/d ) or high-dose ( 2 g/d ) vancomycin or metronidazole ( 1 g/d ) . RESULTS Recurrent CDAD was found to have a lengthy course involving multiple episodes of diarrhea , abdominal cramping , nausea , and fever . CDAD may recur over several years despite frequent treatment with antibiotics . Recurrence rates were similar regardless of the choice or dose of antibiotic . Recurrent CDAD is not a trivial disease : patients may have multiple episodes ( as many as 14 ) , may require hospitalization , and the mean lifetime cost of direct medical care was $ 10,970 per patient . Fortunately , the disease does not become progressively more severe as the number of episodes increase . Two risk factors predictive for recurrent CDAD were found : increasing age and a decreased quality -of-life score at enrollment . CONCLUSIONS Recurrent CDAD is a persistent disease that may result in prolonged hospital stays , additional medical costs , and rare serious complications
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 .