CRP predicts metronidazole treatment failure in C. difficile infection

C-reactive protein is a useful predictor of metronidazole treatment failure in mild-to-moderate Clostridium difficile infection, reports the most recent issue of the European Journal of Gastroenterology & Hepatology.

Dr Hugo Farne and colleagues assessed the ability of C-reactive protein, against the other commonly used metrics, to predict metronidazole treatment failure in Clostridium difficile infection.

The team retrospectively reviewed the case notes of 65 patients with Clostridium difficile infection initially treated with metronidazole.

Patients were grouped on the basis of outcome, as those who responded to metronidazole within 6 days versus those who required vancomycin.

Creatinine levels were significantly different across the groups

European Journal of Gastroenterology & Hepatology

The team examined individual predictor variables between groups, and the strength of associations was assessed by logistic regression.

Of the 65 patients reviewed, 48 resolved with metronidazole alone.

The researchers showed that that C-reactive protein, white cell count, and creatinine levels were significantly different across the metronidazole success/failure groups.

Dr Farne's team concludes "C-reactive protein is a useful predictor of metronidazole treatment failure in mild-to-moderate Clostridium difficile infection."