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Description

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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