Pseudomembranous colitis medical therapy

Revision as of 18:03, 19 October 2012 by Maheep Sangha (talk | contribs)
Jump to navigation Jump to search


Pseudomembranous colitis Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Pseudomembranous Colitis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Pseudomembranous colitis medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Pseudomembranous colitis medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Pseudomembranous colitis medical therapy

CDC on Pseudomembranous colitis medical therapy

Pseudomembranous colitis medical therapy in the news

Blogs on Pseudomembranous colitis medical therapy

Directions to Hospitals Treating Pseudomembranous colitis

Risk calculators and risk factors for Pseudomembranous colitis medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Please help WikiDoc by adding more content here. It's easy! Click here to learn about editing.

Medical Therapy

The disease is usually treated with metronidazole (400 mg every 8 hours). Oral vancomycin (125 mg every 6 hourly) is an alternative but, due to its cost, is often reserved for those patients who have experienced a relapse after a course of metronidazole (a common outcome). Vancomycin treatment also presents the risk of the development of vancomycin resistant enterococcus, and its use for the treatment of C. Difficile infection is now questioned by some institutions. Occasionally metronidazole has been associated with the development of pseudomembranous colitis. In these cases metronidazole is still an effective treatment, since the cause of the colitis is not the antibiotic, but rather the change in bacterial flora from a previous round of antibiotics.

Adjunctive therapy may include cholestyramine, a bile acid resin that can be used to bind C. difficile toxin.

Saccharomyces boulardii (a yeast) has been shown in one small study of 124 patient to reduce the recurrence rate of pseudomembranous colitis.[1] A number of mechanisms have been proposed to explain this effect.

Fecal bacteriotherapy, a procedure related to probiotic research, has been suggested as an alternative cure for the disease. It involves infusion of bacterial flora acquired from the feces of a healthy donor in an attempt to repair the bacterial imbalance responsible for the recurring nature of the infection.

Anecdotal evidence suggests kefir can help treat pseudomembranous colitis.

If antibiotics do not control the infection the patient may require a colectomy (removal of the colon) for treatment of the colitis.

References

  1. McFarland LV, Surawicz CM, Greenberg RN; et al. (1994). "A randomized placebo-controlled trial of Saccharomyces boulardii in combination with standard antibiotics for Clostridium difficile disease". JAMA. 271 (24): 1913&ndash, 18. PMID 8201735.