Overgrowth of Vancomycin-Resistant Enterococci During CDAD Treatment

Oral metronidazole and oral vancomycin promoted similar overgrowth of vancomycin-resistant enterococci during treatment of Clostridium difficile–associated disease in patients with VRE colonization at baseline.

Oral metronidazole and oral vancomycin are standard treatments for Clostridium difficile–associated disease (CDAD); however, both have been associated with the growth of vancomycin-resistant enterococci (VRE). In this prospective, observational study, researchers compared VRE concentrations in stool samples collected from patients who received CDAD treatment with oral metronidazole or oral vancomycin.

Ninety courses of treatment were analyzed. VRE colonization was present at the time of treatment initiation in 56 courses (62%), 37 involving metronidazole and 19 vancomycin. In these colonized cases, the two drugs promoted similar VRE overgrowth, which declined within 2 weeks of treatment cessation. In the 34 courses administered to patients w…

Reviewing Author

Lynn Estes, PharmD

Disclosures

Editorial boardsMayo Clinic Antimicrobial Therapy Quick Guide

Lynn Estes, PharmD

Disclosures

Editorial boardsMayo Clinic Antimicrobial Therapy Quick Guide