Debast et al reported markers associated with an unfavorable outcome for a patient with Clostridium difficile disease. The authors are from multiple institutions in Europe.
Patient selection: Clostridium difficile disease
Parameters:
(1) age in years
(2) continued use of non-CDI antibiotics after diagnosis and/or treatment
(3) severe comorbidity including renal failure
(4) history of 2 or more recurrences
(5) concomitant use of proton pump inhibitors
(6) initial disease severity
Parameter
Finding
Points
age in years
<= 65 years
0
> 65 years
1
continued use of antibiotics
no
0
yes
1
comorbidity
none, mild or moderate
0
severe and/or immunodeficiency
1
number of recurrences
0 or 1
0
2 or more
1
concomitant therapy with proton pump inhibitor
no
0
yes
1
initial disease severity
none, mild, moderate
0
severe
1
where:
• The risk for recurrence related to continued antibiotic therapy may relate to the antibiotic's risk profile for Clostridium difficile.
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the greater the risk of disease recurrence.
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