Table 2.
Univariate Analysis of Risk Factors Associated with Metronidazole Failure in the 2004–2006 Cohort
| Variable | Change to vancomycin (n = 14) | Duration of diarrhea >10 days (n = 14) | Total metronidazole failure (n = 28) | No metronidazole failure (n = 51) | P value* |
|---|---|---|---|---|---|
| Age (year), median (range) | 83 (22–93) | 74 (48–94) | 76 (22–94) | 68 (29–91) | 0.09 |
| ≥65, n (%) | 10 (71%) | 11 (79%) | 21 (75%) | 30 (58%) | 0.15 |
| ≥85, n (%) | 5 (36%) | 2 (14%) | 7 (25%) | 6 (12%) | 0.14 |
|
| |||||
| Male sex, n (%) | 7 (50%) | 8 (57%) | 15 (54%) | 22 (42%) | 0.29 |
|
| |||||
| White race, n (%) | 13 (93%) | 13 (93%) | 26 (93%) | 39 (75%) | 0.06 |
|
| |||||
| Residence before admission, n (%) | |||||
| Home | 6 (43%) | 7 (50%) | 13 (46%) | 34 (67%) | 0.08 |
| Nursing home or rehabilitation center | 5 (36%) | 3 (21%) | 8 (29%) | 11 (22%) | 0.49 |
| Other hospital | 3 (21%) | 4 (29%) | 7 (25%) | 6 (12%) | 0.14 |
|
| |||||
| Prior CDI, n (%) | 1 (7%) | 2 (14%) | 3 (11%) | 7 (14%) | 0.70 |
|
| |||||
| Number of recently used antibiotics, median (range) | 3 (1–9) | 3 (1–6) | 3 (1–9) | 2 (0–7) | 0.20 |
| Clindamycin, n (%) | 2 (14%) | 0 | 2 (7%) | 7 (14%) | 0.39 |
| Metronidazole, n (%) | 2 (14%) | 2 (14%) | 4 (14%) | 9 (18%) | 0.70 |
| Vancomycin, n (%) | 6 (43%) | 6 (43%) | 12 (43%) | 21 (41%) | 0.88 |
| Penicillin, n (%) | 2 (14%) | 2 (14%) | 4 (14%) | 11 (22%) | 0.43 |
| Cephalosporin, n (%) | 8 (57%) | 9 (64%) | 17 (61%) | 15 (29%) | 0.008 |
| Carbopenem, n (%) | 4 (29%) | 1 (7%) | 5 (18%) | 6 (12%) | 0.46 |
| Macrolide, n (%) | 2 (14%) | 4 (29%) | 6 (21%) | 5 (10%) | 0.16 |
| Fluoroquinolone, n (%) | 10 (71%) | 8 (57%) | 18 (64%) | 26 (51%) | 0.26 |
| Aminoglycoside, n (%) | 0 | 0 | 0 | 3 (6%) | 0.98 |
| Sulfonomide, n (%) | 3 (21%) | 0 | 3 (11%) | 6 (12%) | 0.89 |
|
| |||||
| Acid anti-secretory medication, n (%) | 12 (86%) | 11 (79%) | 23 (82%) | 38 (75%) | 0.44 |
| H-2RA | 3 (21%) | 1 (7%) | 4 (14%) | 7 (14%) | 0.95 |
| PPI | 11 (79%) | 10 (71%) | 21 (75%) | 36 (71%) | 0.68 |
|
| |||||
| TPN, n (%) | 0 | 1 (7%) | 1 (4%) | 4 (8%) | 0.47 |
|
| |||||
| Tube feeding, n (%) | 1 (7%) | 0 | 1 (4%) | 3 (6%) | 0.66 |
|
| |||||
| Charlson score, median (range) | 5 (1–11) | 3 (0–10) | 4 (0–11) | 3 (0–10) | 0.32 |
|
| |||||
| Horn’s index severe to fulminant, n (%) | 5 (36%) | 5 (36%) | 10 (36%) | 10 (20%) | 0.12 |
|
| |||||
| Immunosuppression, n (%) | 8 (57%) | 5 (36%) | 13 (46%) | 18 (35%) | 0.35 |
|
| |||||
| ICU admission before or at time of CDI diagnosis, n (%) | 3 (21%) | 5 (36%) | 8 (29%) | 14 (27%) | 0.92 |
|
| |||||
| Length of stay before CDI diagnosis, median (range) | 1, 0–11 | 2, 0–29 | 1 (0–29) | 2 (0–27) | 0.89 |
|
| |||||
| CDI on admission, n (%) | 10 (71%) | 8 (57%) | 18 (64%) | 22 (43%) | 0.08 |
|
| |||||
| Severe CDI, n (%) | 10 (71%) | 1 (7%) | 11 (39%) | 18 (35%) | 0.72 |
|
| |||||
| Albumin (g/dl), median (range) | 2.6 (2.1–3.4) (n = 9) | 2.9 (2.5–3.8) (n = 10) | 2.8 (2.1–3.8) (n = 19) | 3.1 (2–4.3) (n = 31) | 0.08 |
| ≤2.5, n (%) | 4 (44%) | 1 (10%) | 5 (26%) | 6 (19%) | 0.57 |
|
| |||||
| WBC (/μl), median (range) | 18 (0.4–41.2) | 14.3 (0.2–32.5) | 16 (0.2–41.2) | 12.3 (0.2–40.6) | 0.15 |
| ≥15,000, n (%) | 9 (64%) | 6 (43%) | 15 (54%) | 16 (31%) | 0.06 |
| ≥20,000, n (%) | 6 (43%) | 1 (7%) | 7 (25%) | 9 (18%) | 0.44 |
|
| |||||
| Cr (mg/dl), median (range) | 1.7 (0.7–11.5) | 1.1 (0.6–5.7) | 1.3 (0.6–11.5) | 1.3 (0.4–9.9) (n = 50) | 0.74 |
| ≥2.3, n (%) | 5 (36%) | 2 (14%) | 7 (25%) | 12 (24%) | 0.92 |
|
| |||||
| Ileus, n (%) | 2 (17%) (n = 12) | 1 (25%) (n = 4) | 3 (19%) (n = 16) | 1 (4%) (n = 23) | 0.18 |
|
| |||||
| Colitis, n (%) | 9 (75%) (n = 12) | 0 (n = 2) | 9 (64%) (n = 14) | 10 (48%) (n = 21) | 0.34 |
|
| |||||
| Duration of diarrhea before CDI treatment (day), median (range) | 2, 0–28 | 1, 0–14 | 2 (0–28) | 2 (0–21) | 0.85 |
|
| |||||
| Concurrent antibiotic use, n (%) | 14 (100%) | 9 (64%) | 23 (82%) | 37 (73%) | 0.34 |
|
| |||||
| NAP-1, n (%) | 3 (43%) (n = 7) | 2 (17%) (n = 12) | 5 (26%) (n= 19) | 7 (21%) (n = 33) | 0.67 |
*
P value for total metronidazole failure vs. no metronidazole failure