The role of vancomycin and metronidazole for the treatment of Clostridium difficile-associated diarrhea

J Pharm Pract. 2013 Oct;26(5):488-90. doi: 10.1177/0897190013499525. Epub 2013 Aug 12.

Abstract

For the treatment of Clostridium difficile-associated diarrhea (CDAD), metronidazole and vancomycin remain the most commonly used agents. The major advantage of metronidazole is its low cost, while the advantage of oral vancomycin is a more favorable pharmacokinetic profile. The epidemiology and clinical severity of CDAD have changed due to the emergence of a hypervirulent strain (BI/NAP1/027). In 2010, the Infectious Diseases Society of America/Society for Health Care Epidemiology of America expert panel defined severe CDAD and recommended oral vancomycin to treat these patients. Metronidazole remains the preferred agent for treatment of mild to moderate CDAD.

Keywords: clostridium difficile treatment; metronidazole; oral vancomycin.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Ophthalmic
  • Anti-Bacterial Agents / economics
  • Anti-Bacterial Agents / pharmacokinetics
  • Anti-Bacterial Agents / therapeutic use*
  • Clostridioides difficile / isolation & purification*
  • Clostridium Infections / drug therapy*
  • Clostridium Infections / epidemiology
  • Clostridium Infections / microbiology
  • Diarrhea / drug therapy*
  • Diarrhea / epidemiology
  • Diarrhea / microbiology
  • Drug Costs
  • Humans
  • Metronidazole / economics
  • Metronidazole / pharmacokinetics
  • Metronidazole / therapeutic use
  • Severity of Illness Index
  • Vancomycin / economics
  • Vancomycin / pharmacokinetics
  • Vancomycin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Metronidazole
  • Vancomycin