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Clostridium difficile infection (CDI) is an urgent clinical problem with a rapidly rising prevalence. Guidelines recommend oral metronidazole as the treatment of choice for most patients and oral vancomycin for seriously ill individuals. For patients who cannot take oral medications, intravenous metronidazole is the only option — but is it equivalent to oral treatment?
To explore this issue, researchers in Austria conducted a hospital-based, prospective cohort study involving patients with mild CDI (i.e., without pseudomembranous colitis at onset, peritonitis, ileus, toxic megacolon, marked leukocytosis, rise in creatinine or lactate level, or other signs of severe colitis). All patients were able to take oral medication; choice of regimen …