the george inn
Among patients with Clostridium difficile infection (CDI) who recovered following standard treatment with the antibiotics metronidazole or vancomycin, oral administration of spores of a strain of C difficile that does not produce wholesale nfl jerseys toxins colonized the gastrointestinal tract and significantly reduced CDI recurrence, according to a study in the May 5 issue wholesale nfl jerseys of JAMA. deaths each year. hospitals. Clinical infection also has a recurrence wholesale nfl jerseys rate of 25 percent to 30 percent among affected patients. Not all strains of C difficile produce toxins. Nontoxigenic C difficile strains that lack the genes for toxin production are also found in the hospital environment and can colonize hospitalized patients, although patients are usually asymptomatic. Gastrointestinal colonization by these nontoxigenic C difficile strains (in both humans and hamsters) has shown promising results as a potential way to prevent CDI, according to background information in the article.
Dale N. VA Hospital, Hines, Il., and Loyola University Chicago, Maywood, Il., and colleagues randomly assigned 173 adult patients who were diagnosed as having CDI (first episode or first recurrence) to receive 1 of 4 treatments: oral liquid formulation of nontoxigenic C difficile strain M3 (VP20621; NTCD M3), 104 spores/d for 7 days (n = 43), 107 spores/d for 7 days (n = 44), 107 spores/d for 14 days (n = 42), or placebo for 14 days (n = 44). Prior to enrollment, these patients had all successfully completed treatment with metronidazole, oral vancomycin, or both at 44 study centers in the United States, Canada, and Europe.
Among 168 patients who started treatment, 157 completed treatment. Clostridium difficile infection recurrence was 30 percent among patients receiving placebo compared with 11 percent among all patients receiving NTCD M3. The lowest recurrence was in 5 percent of patients receiving 107 spores/d for 7 days. Fecal colonization with NTCD M3 occurred in 69 percent of NTCD M3 patients: 71 percent with 107 spores/d and 63 percent with 104 spores/d. Colonization with NTCD correlated with reduced recurrence of CDI: recurrence occurred in 2 percent patients who were colonized vs 31 percent of patients who received NTCD M3 but were not colonized.
One or more treatment emergent adverse events were reported in 78 percent of patients receiving NTCD M3 and 86 percent of patients receiving placebo. Diarrhea and abdominal pain were reported in 46 percent and 17 percent of patients receiving NTCD M3 and 60 percent and 33 percent of placebo patients, respectively. Serious treatment emergent adverse events were reported in 7 percent of patients receiving placebo and 3 percent of all patients who received NTCD M3. Headache was reported in 10 percent of patients receiving NTCD M3 and 2 percent of placebo patients.
The researchers write that the mechanism by which NTCD prevents recurrent CDI is not known; however, there may be an association with the presence of NTCD in the stool (colonization) with reduced infection from toxigenic wholesale jerseys from china C difficile and in animal models with prevention of CDI when challenged with toxigenic strains.
Editor’s Note: This study was sponsored by ViroPharma Incorporated, which is now part of the Shire group of companies.Articles Connexes：