Antibiotic treatment for Clostridium difficile-associated diarrhoea in adults.

Nelson RL, Suda KJ, Evans CT et al.

Epidemiology/Biometry Division, University of Illinois School of Public Health, 1603 West Taylor, Room 956, Chicago, Illinois, USA, 60612.

The Cochrane database of systematic reviews. Mar 2017.

Clostridium difficile (C. difficile) is recognized as a frequent cause of antibiotic-associated diarrhoea and colitis. This review is an update of a previously published Cochrane review.The aim of this review is to investigate the efficacy and safety of antibiotic therapy for C. difficile-associated diarrhoea (CDAD), or C. difficile infection (CDI), being synonymous terms.We searched MEDLINE, EMBASE, CENTRAL and the Cochrane IBD Group Specialized Trials Register from inception to 26 January 2017. We also searched and for ongoing trials.Only randomised controlled trials assessing antibiotic treatment for CDI were included in the review.Three authors independently assessed abstracts and full text articles for inclusion and extracted data. The risk of bias was independently rated by two authors. For dichotomous outcomes, we calculated the risk ratio (RR) and corresponding 95% confidence interval (95% CI). We pooled data using a fixed-effect model, except where significant heterogeneity was detected, at which time a random-effects model was used. The following outcomes were sought: sustained symptomatic cure (defined as initial symptomatic response and no recurrence of CDI), sustained bacteriologic cure, adverse reactions to the intervention, death and cost.


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