Relationship between faecal metronidazole and lactoferrin concentrations to clinical response of patients with Clostridioides difficile

• Published in: European journal of clinical microbiology & infectious diseases Vol. 39; no. 9; pp. 1781 - 1784
• Main Authors: Saunders, Maria, Jeffery, Jinny, Vincent, Zoe, Ayling, Ruth M., Lewis, Stephen
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2020; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Anti-Bacterial Agents - metabolism; Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Biomedical and Life Sciences; Biomedicine; Brief Report; Clostridioides difficile - drug effects; Clostridioides difficile - metabolism; Correlation; Diarrhea; Enterocolitis, Pseudomembranous - blood; Enterocolitis, Pseudomembranous - drug therapy; Enterocolitis, Pseudomembranous - microbiology; Feces - chemistry; Female; Humans; Internal Medicine; Lactoferrin; Lactoferrin - metabolism; Male; Markers; Medical Microbiology; Metronidazole; Metronidazole - metabolism; Metronidazole - pharmacology; Metronidazole - therapeutic use; Faecal metronidazole; Faecal lactoferrin; Clostridioides difficile
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s10096-020-03895-8

Objectives We investigated patients with Clostridioides difficile -associated diarrhoea to see if clinical resolution correlated with faecal concentrations of metronidazole or markers of inflammation. Methods Faecal metronidazole, lactoferrin and serum CRP were measured daily. These were then compared with clinical progress. Results Metronidazole concentration correlated with lactoferrin ( ρ  = 0.17, p  = 0.015), CRP ( ρ  = 0.23, p  < 0.001) and number of diarrhoeal stools per day ( ρ  = 0.29, p  < 0.001). Lactoferrin correlated with CRP ( ρ  = 0.57, p  < 0.001) and the number of diarrhoeal stools per day ( ρ  = 0.52, p  < 0.001) as did CRP ( ρ  = 0.52, p  < 0.001). Conclusions We found no association between cessation of diarrhoea and metronidazole or lactoferrin concentrations. There was a relationship between metronidazole concentrations and markers of inflammation and stool frequency.