A randomized, double-blind study comparing Clostridium difficile immune whey and metronidazole for recurrent Clostridium difficile-associated diarrhoea: efficacy and safety data of a prematurely interrupted trial

Scand J Infect Dis. 2008;40(9):702-8. doi: 10.1080/00365540801964960.

Abstract

A prospective, randomized, double-blind study was designed to compare Clostridium difficile immune whey (CDIW) with metronidazole for treatment of laboratory-confirmed, recurrent, mild to moderate episodes of Clostridium difficile-associated diarrhoea (CDAD). CDIW was manufactured by immunization of cows in their gestation period with inactivated C. difficile vaccine. The resulting colostrum was processed, immunoglubulins were concentrated and the end-product containing high titres of C. difficile immunoglobulin was used as CDIW. 20 patients received metronidazole at a dosage of 400 mg t.i.d. and 18 patients CDIW 200 ml t.i.d. The study was interrupted early because of the bankruptcy of the sponsor. After 14 d of treatment, all 20 (100%) of 20 patients had responded to metronidazole therapy, compared with 16 (89%) of 18 who had received CDIW. 70 d after the beginning of treatment, sustained responses were observed in 11 (55%) of 20 patients receiving metronidazole and 10 (56%) of 18 patients treated with CDIW. In this preliminary study CDIW was as effective as metronidazole in the prevention of CDAD recurrences and it was well tolerated.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Animals
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Cattle
  • Clostridioides difficile / immunology*
  • Clostridium Infections* / drug therapy
  • Clostridium Infections* / immunology
  • Clostridium Infections* / prevention & control
  • Diarrhea* / drug therapy
  • Diarrhea* / immunology
  • Diarrhea* / prevention & control
  • Double-Blind Method
  • Female
  • Humans
  • Immunization
  • Immunotherapy
  • Male
  • Metronidazole / administration & dosage
  • Metronidazole / therapeutic use*
  • Middle Aged
  • Milk Proteins / administration & dosage
  • Milk Proteins / immunology*
  • Treatment Outcome
  • Whey Proteins
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Milk Proteins
  • Whey Proteins
  • Metronidazole