Diarrhea Clinical Trial
Official title:
A Double-Blind, Randomized, Controlled Trial of Rifaximin Compared to Vancomycin for the Treatment of Clostridium Difficile-Associated Diarrhea (CDAD)
The purpose of this study is to assess the treatment and safety of a 10-day course of rifaximin (Xifaxan) as compared to vancomycin for treatment of Clostridium difficile-associated diarrhea (CDAD).
Clostridium difficile is a bacterium that proliferates when normal colonic flora have been
altered, most commonly due to antibiotic use. Clostridium difficile is non-invasive and
localized to the lumen of the colon. Once established, it produces 2 potent toxins, A and B.
The principal reservoir for Clostridium difficile is the hospital environment, with the risk
of acquiring Clostridium difficile increasing in direct proportion to the length of hospital
stay.
Patients with CDAD typically present with profuse watery or mucoid diarrhea and cramping
abdominal pain. Additional symptoms include fever, nausea, anorexia, malaise, and bloody
stool. More severe cases may be complicated by dehydration, electrolyte disturbances, ileus,
and peritonitis. Systemic manifestations may include prerenal azotemia, sepsis syndrome, and
toxic colitis. White blood cell counts (WBCs) also may be markedly elevated with a shift to
immature forms. Extreme presentation of fulminant colitis may require a colectomy and even
result in death. Symptoms of CDAD may begin a few days after initiation of antibiotic therapy
or up to 8 weeks after its discontinuation.
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