Clostridium difficile colitis associated with treatment of Helicobacter pylori infection

Abstract

Helicobacter pylori infection of the stomach is being detected and treated more often now than ever before. This is likely to result in an increase in complications such as antibiotic-associated diarrhea. However, there is no literature on the incidence of such diarrhea, particularly Clostridium difficile colitis, in patients treated for Helicobacter pylori infection. We report the case of a patient who developed Clostridium difficile colitis after treatment for Helicobacter pylori infection with metronidazole, amoxicillin, H2 blockers, and bismuth subsalicylate. This patient presented with severe diarrhea that responded to a course of metronidazole with rapid disappearance of symptoms. The incidence of Clostridium difficile colitis in patients treated for Helicobacter pylori infection has not been studied. This unique association, although not unexpected, has not yet been reported in the literature. The increasing number of patients being diagnosed and treated for this infection requires a heightened awareness on the part of physicians, to assure early diagnosis and treatment of this treatable, yet potentially dangerous, complication.

The role of endoscopy in dyspepsia

“…27,28 It is important to note that the prevalence rates of H pylori in the United States are lower than in developing countries and may vary by region and target population. Hence, testing and treating for H pylori may be relevant and cost-effective in regions with prevalence rates of H pylori of 20% or higher.…”

Targeting the Human Microbiome With Antibiotics, Probiotics, and Prebiotics: Gastroenterology Enters the Metagenomics Era

“…40 A separate study showed overgrowth of potentially pathogenic organisms, including drug-resistant Enter-obacteriaceae and yeasts. 41 These changes could account for reports of treatment-associated C. difficile colitis 42 and other forms of diarrhea that can reduce patient compliance. 43 Probiotics, when used in combination with standard antibiotic therapy for H. pylori infection, increased pathogen eradication and reduced the gastrointestinal side effects of conventional therapy, as concluded by a meta-analysis of 14 randomized trials.…”

Risk of Recurrent Helicobacter pylori Infection 1 Year After Initial Eradication Therapy in 7 Latin American Communities

“…5–7,10 Thus, while our data underscore the continued use of 14-day triple therapy in Latin America, from a program perspective they also point to the possible acceptability of a lower-cost regimen (eg, sequential therapy). Assessment of program effectiveness must also consider potential adverse outcomes such as adverse effects of treatment, rare serious events, 37 and the potential contribution to community antimicrobial resistance. 38 In low- and middle-income nations, the incremental effects of an eradication program on resistance are difficult to gauge given the prevalence of unsanitary conditions that facilitate spread of resistant bacteria and the common practice of self-prescription with over-the-counter antibiotics.…”