Vol.58 No.2 March 2010
Successful intrarectal metronidazole administration against Clostridium-difficile-associated colitis
1)Department of Pharmacy, Yokohama Stroke and Brain Center, 1-2-1 Takigashira, Isogo-ku, Yokohama, Kanagawa, Japan
2)Division of Infectious Disease, Kobe University Hospital
Abstract
We report a case of Clostridium-difficile-associated diarrhea treated successfully by intrarectally administering metronidazole vaginal tablets. An 82-year-old man seen for persistent diarrhea and pyrexia, was diagnosed as having Clostridium-difficile-associated diarrhea based on a positive stool assay for Clostridium difficile toxin. Twice-daily oral administration of 500 mg metronidazole tablets was ineffective. Due to the man's ongoing vomiting from polyp-induced pyloric obstruction, we administered 250 mg metronidazole vaginal tablets thrice daily intrarectally. The man's condition improved in a 10-day course.
Intrarectal metronidazole vaginal tablet administration is thus an effective alternative for treating Clostridium-difficile-associated diarrhea in those unable to take medications orally.
Key word
Clostridium difficile-associated disease, metronidazole
Received
November 25, 2008
Accepted
December 28, 2009
Jpn. J. Chemother. 58 (2): 125-127, 2010