Addition of Lactobacillus to Metronidazole in Treatment of CDAD
Addition of Lactobacillus to Metronidazole in Treatment of CDAD
The purpose of this study is to determine whether dietary supplementation with Lactobacillus
 GG will reduce the rate of failure or relapse following treatment of CDAD with metronidazole.
Clostridium difficile associated disease (CDAD), which nearly always follows antibiotic
 therapy, has become increasingly common and important in American hospitals, causing
 substantial morbidity and mortality. Metronidazole is the recommended treatment for this
 condition. We have recently reported (Clin Infect Dis, June 2005) that treatment with
 metronidazole is associated with a 22% rate of failure and 28% rate of relapse. No other
 medication has been shown to be more effective. There is a substantial theory and some
 limited data to suggest that dietary supplementation with non-pathogenic normal bowel
 bacteria will benefit these patients. Lactobacillus GG is the best-standardized and the most
 extensively studied of these agents.
Inclusion Criteria:

 -  Subjects will be identified based on the diagnosis of CDAD. This diagnosis is made
 bases on the presence of diarrhea, fever, abdominal pain and/or leukocytosis together
 with a positive fecal assay for Clostridium difficile toxin

 Exclusion Criteria:

 -  Patients who are unable to take oral medications and those with underlying
 gastrointestinal disease or colonostomy will be excluded.

 -  Patients currently taking penicillins, cephalosporins, quinolones or tetracyclines
 will be excluded because these drugs are active against Lactobacillus.