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Southern Medical Journal:
July 2009 - Volume 102 - Issue 7 - pp 746-747
doi: 10.1097/SMJ.0b013e3181a82bbb
Case Report

Nitazoxanide and Probiotics for the Treatment of Recurrent Clostridium difficile Infection in a Peritoneal Dialysis Patient

Yangco, Bienvenido G. MD, MPH; Sher, Gulab MD; Bardin, Matthew C. PharmD, BCPS

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Abstract

Nitazoxanide has been proven to be efficacious for the treatment of Clostridium difficile infection (CDI), but data is limited in peritoneal dialysis (PD) patients. This report details the successful utilization of nitazoxanide and probiotics to treat multirecurrent CDI in a PD patient. A 58-year-old woman was admitted with hypotension, nausea and vomiting attributed to metronidazole therapy for CDI, her third CDI treatment regimen in 3 months. During her admission, the patient developed CDI and was started on a 6-week regimen of nitazoxanide and probiotics to assist in re-establishing the colonic flora. The regimen was well tolerated and the patient remained disease free at follow up, four months later.

Key Points

* Clostridium difficile infection (CDI), especially multi-recurrent CDI, is a significant problem which is increasing in incidence and severity in hospitalized patients.

* Nitazoxanide and probiotics effectively treated a peritoneal dialysis patient with multirecurrent CDI.

* The overall safety of nitazoxanide is well-established and the pharmacologic characteristics of nitazoxanide are well suited for the treatment of CDI, including patients with renal disease.

© 2009 Southern Medical Association

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