Risk factors for recurrence of Clostridium difficile-associated diarrhea in the elderly

Risk factors that influence the recurrence of nosocomial Clostridium difficile-associated diarrhea (CDAD) were determined in an 18-month follow-up study in a subacute geriatric department. A case-control study was conducted, comparing 43 patients with recurrent C. difficile-associated diarrhea (RCDAD) (case patients) with 38 patients who had only 1 episode of CDAD (control patients). The mean age of patients was 81.6 +/- 7.2 y (range 64-95 y). All cases with CDAD were receiving antibiotic therapy. RCDAD occurred in 53.1% of patients. Risk factors for RCDAD included fecal incontinence (p less than or equal to 0.04), longer duration of fever from admission until first episode of CDAD (p less than or equal to 0.02) and H2-antagonist treatment (p less than or equal to 0.02). This study shows that RCDAD is a common clinical event in elderly hospitalized patients and may be predictable in some groups of patients.