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  • 1. Aims and Scope

    Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut atnd Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. +MORE

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    Editor-in-Chief
    Yong Chan Lee Professor of Medicine
    Director, Gastrointestinal Research Laboratory
    Veterans Affairs Medical Center, Univ. California San Francisco
    San Francisco, USA

    Deputy Editor

    Deputy Editor
    Jong Pil Im Seoul National University College of Medicine, Seoul, Korea
    Robert S. Bresalier University of Texas M. D. Anderson Cancer Center, Houston, USA
    Steven H. Itzkowitz Mount Sinai Medical Center, NY, USA
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    All papers submitted to Gut and Liver are reviewed by the editorial team before being sent out for an external peer review to rule out papers that have low priority, insufficient originality, scientific flaws, or the absence of a message of importance to the readers of the Journal. A decision about these papers will usually be made within two or three weeks.
    The remaining articles are usually sent to two reviewers. It would be very helpful if you could suggest a selection of reviewers and include their contact details. We may not always use the reviewers you recommend, but suggesting reviewers will make our reviewer database much richer; in the end, everyone will benefit. We reserve the right to return manuscripts in which no reviewers are suggested.

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Alimentary Tract

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Risk Factors for Treatment Failure and Recurrence after Metronidazole Treatment for Clostridium difficile-associated Diarrhea

Kyu Sik Jung*, Jae Jun Park*, Young Eun Chon*, Eun Suk Jung*, Hyun Jung Lee*, Hui Won Jang*, Kyong Joo Lee*, Sang Hoon Lee*, Chang Mo Moon*, Jin Ha Lee*, Jae Kook Shin*, Soung Min Jeonc, Sung Pil Hong*,†, Tae Il Kim*,†, Won Ho Kim*,†,‡, and Jae Hee Cheon*,†,‡

*Department of Internal Medicine and †Institute of Gastroenterology, and ‡Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea

Correspondence to: Jae Hee Cheon

Gut Liver 2010;4(3):332-337. https://doi.org/10.5009/gnl.2010.4.3.332

Published online November 30, -0001, Published date September 30, 2010

Copyright © Gut and Liver.

Abstract

Background/Aims: The incidence of treatment failure or recurrence of Clostridium difficile-associated diarrhea (CDAD) following metronidazole treatment has increased recently. We studied the treatment failure, recurrence rate, and risk factors predictive of treatment failure and recurrence after metronidazole treatment for CDAD. Methods: We retrospectively identified consecutive patients who were admitted and treated for CDAD at a single tertiary institution in Korea over a recent 10-year period (i.e., 1998-2008). Results: Metronidazole was administered as the initial treatment to 111 of 117 patients (94.9%) with CDAD. Fourteen patients (12.6%) had no clinical response to the metronidazole treatment, and in 13 patients (13.4%) CDAD recurred after successful metronidazole treatment. Diabetes mellitus (p=0.014) and sepsis (p=0.002) were independent risk factors for metronidazole treatment failure. Patients who had received surgery within 1 month before CDAD developed were more likely to experience a recurrence after metronidazole treatment (p=0.032). Vancomycin exhibited a higher response rate after treatment failure, and metronidazole showed a reasonable response rate in the treatment of recurrence. Treatment failure and recurrence rates increased with time after metronidazole treatment for CDAD over the 10-year study period. Conclusions: Our data suggest that diabetes mellitus and sepsis are independent risk factors for metronidazole treatment failure, and that operation history within 1 month of development of CDAD is a predictor of a recurrence after metronidazole treatment. (Gut Liver 2010;4:332-337)

Keywords: Clostidium difficile-associated diarrhea, Metronidazole, Vancomycin


Article

Alimentary Tract

Gut and Liver 2010; 4(3): 332-337

Published online September 30, 2010 https://doi.org/10.5009/gnl.2010.4.3.332

Copyright © Gut and Liver.

Risk Factors for Treatment Failure and Recurrence after Metronidazole Treatment for Clostridium difficile-associated Diarrhea

Kyu Sik Jung*, Jae Jun Park*, Young Eun Chon*, Eun Suk Jung*, Hyun Jung Lee*, Hui Won Jang*, Kyong Joo Lee*, Sang Hoon Lee*, Chang Mo Moon*, Jin Ha Lee*, Jae Kook Shin*, Soung Min Jeonc, Sung Pil Hong*,†, Tae Il Kim*,†, Won Ho Kim*,†,‡, and Jae Hee Cheon*,†,‡

*Department of Internal Medicine and †Institute of Gastroenterology, and ‡Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea

Correspondence to:Jae Hee Cheon

Abstract

Background/Aims: The incidence of treatment failure or recurrence of Clostridium difficile-associated diarrhea (CDAD) following metronidazole treatment has increased recently. We studied the treatment failure, recurrence rate, and risk factors predictive of treatment failure and recurrence after metronidazole treatment for CDAD. Methods: We retrospectively identified consecutive patients who were admitted and treated for CDAD at a single tertiary institution in Korea over a recent 10-year period (i.e., 1998-2008). Results: Metronidazole was administered as the initial treatment to 111 of 117 patients (94.9%) with CDAD. Fourteen patients (12.6%) had no clinical response to the metronidazole treatment, and in 13 patients (13.4%) CDAD recurred after successful metronidazole treatment. Diabetes mellitus (p=0.014) and sepsis (p=0.002) were independent risk factors for metronidazole treatment failure. Patients who had received surgery within 1 month before CDAD developed were more likely to experience a recurrence after metronidazole treatment (p=0.032). Vancomycin exhibited a higher response rate after treatment failure, and metronidazole showed a reasonable response rate in the treatment of recurrence. Treatment failure and recurrence rates increased with time after metronidazole treatment for CDAD over the 10-year study period. Conclusions: Our data suggest that diabetes mellitus and sepsis are independent risk factors for metronidazole treatment failure, and that operation history within 1 month of development of CDAD is a predictor of a recurrence after metronidazole treatment. (Gut Liver 2010;4:332-337)

Keywords: Clostidium difficile-associated diarrhea, Metronidazole, Vancomycin

Gut and Liver

Vol.18 No.3
May, 2024

pISSN 1976-2283
eISSN 2005-1212

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