PT  - JOURNAL ARTICLE
AU  - Susan M. Poutanen
AU  - Andrew E. Simor
TI  - <em>Clostridium difficile</em>-associated diarrhea in adults
AID  - 10.1503/cmaj.1031189
DP  - 2004 Jul 06
TA  - Canadian Medical Association Journal
PG  - 51--58
VI  - 171
IP  - 1
4099  - http://www.cmaj.ca/content/171/1/51.short
4100  - http://www.cmaj.ca/content/171/1/51.full
SO  - CMAJ2004 Jul 06; 171
AB  - CLOSTRIDIUM DIFFICILE is the most important cause of nosocomial diarrhea in adults. Illness may range from mild watery diarrhea to life-threatening colitis. An antecedent disruption of the normal colonic flora followed by exposure to a toxigenic strain of C. difficile are necessary first steps in the pathogenesis of disease. Diagnosis is based primarily on the detection of C. difficile toxin A or toxin B. First-line treatment is with oral metronidazole therapy. Treatment with oral vancomycin therapy should be reserved for patients who have contraindications or intolerance to metronidazole or who fail to respond to first-line therapy.