Journal
BIOSCIENCE OF MICROBIOTA FOOD AND HEALTH
Volume 41, Issue 2, Pages 37-44Publisher
BMFH PRESS
DOI: 10.12938/bmfh.2021-049
Keywords
Clostridioides difficile infection; Clostridium butyricum; diabetes mellitus; probiotics; metronidazole
Categories
Funding
- Ministry of Science and Technology, Taiwan [MOST 108-2321-B-006-004, 108-2320-B-006-043-MY3, 109-2314-B-006-089-MY3, 110-2314-B-675-001]
- Ministry of Health and Welfare, Taiwan [MOHW110-TDU-B-211-124003]
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The study found that the therapeutic effect of Clostridium butyricum for adult patients with Clostridioides difficile infection (CDI) was non inferior to metronidazole, but patients with diabetes mellitus had a lower treatment success rate.
The therapeutic effect of Clostridium butyricum for adults with Clostridioides difficile infection (CDI) was investigated. A retrospective study was conducted in medical wards of Tainan Hospital, Ministry of Health and Welfare, between January 2013 and April 2020. The disease severity of CDI was scored based on the Clinical Practice Guidelines of the IDSA/SHEA. Treatment success was defined as the resolution of diarrhea within six days of a therapeutic intervention without the need to modify the therapeutic regimen. In total, 241 patients developed CDI during hospitalization in the study period. The treatment success rates for the 99 patients with mild-moderate CDI among them were as follows: metronidazole, 69.4%; C. butyricum, 68.2%; metronidazole plus C. butyricum, 66.7%; and oral vancomycin, 66.7% (p=1.00). Patients with treatment success were less likely to have diabetes mellitus than those with treatment failure (38.2% vs. 61.3%, p=0.05). Patients treated with C. butyricum alone or in combination with metronidazole had shorter durations of diarrhea than those treated with metronidazole alone (3.1 +/- 2.0 days or 3.5 +/- 2.4 days vs. 4.2 +/- 3.5 days; p=0.43 or 0.71), although the differences were not statistically significant. In conclusion, the treatment success rate of C. butyricum alone or in combination with metronidazole for patients with CDI was non inferior to that of metronidazole alone. The presence of diabetes mellitus in affected individuals is a risk factor for treatment failure.
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