CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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Clostridium difficile is the most important cause of nosocomial diarrhea in adults. Illness may range from mild watery diarrhea to life-threatening colitis. ⋯ First-line treatment is with oral metronidazole therapy. Treatment with oral vancomycin therapy should be reserved for patients who have contraindications or intolerance to metronidazole or who fail to respond to first-line therapy.
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Multicenter Study
Risk of Clostridium difficile diarrhea among hospital inpatients prescribed proton pump inhibitors: cohort and case-control studies.
Antibiotic disruption of the normal intestinal flora is a well-known risk factor for Clostridium difficile-associated diarrhea. Reduced gastric acidity has been suggested as a risk factor, and we hypothesized that proton pump inhibitors, because of their potency, may be an independent risk factor for this problem. ⋯ Patients in hospital who received proton pump inhibitors were at increased risk of C. difficile diarrhea.
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Comparative Study
Lack of insurance coverage for testing supplies is associated with poorer glycemic control in patients with type 2 diabetes.
Public insurance for testing supplies for self-monitoring of blood glucose is highly variable across Canada. We sought to determine if insured patients were more likely than uninsured patients to use self-monitoring and whether they had better glycemic control. ⋯ Patients without insurance for self-monitoring test strips had poorer glycemic control.