ABSTRACT
In recent decades, Clostridium difficile infection (CDI) has become a worldwide health problem. Mexico is no exception, and therefore the Asociación Mexicana de Gastroenterología brought together a multidisciplinary group (gastroenterologists, endoscopists, internists, infectious disease specialists, and microbiologists) to carry out the "Consensus on the prevention, diagnosis, and treatment of Clostridium difficile infection", establishing useful recommendations (in relation to the adult population) for the medical community. Said recommendations are presented herein. Among them, it was recognized that CDI should be suspected in subjects with diarrhea that have a history of antibiotic and/or immunosuppressant use, but that it can also be a community-acquired infection. A 2-step diagnostic algorithm was proposed, in which a highly sensitive test, such as glutamate dehydrogenase (GDH), is first utilized, and if positive, confirmed by the detection of toxins through immunoassay or nucleic acid detection tests. Another recommendation was that CDI based on clinical evaluation be categorized as mild-moderate, severe, and complicated severe, given that such a classification enables better therapeutic decisions to be made. In mild-moderate CDI, oral vancomycin is the medication of choice, and metronidazole is recommended as an alternative treatment. In addition, fecal microbiota transplantation was recognized as an efficacious option in patients with recurrence or in the more severe cases of infection, and surgery should be reserved for patients with severe colitis (toxic megacolon), in whom all medical treatment has failed.
Subject(s)
Clostridioides difficile , Clostridium Infections/therapy , Clostridium Infections/diagnosis , Clostridium Infections/prevention & control , Consensus , Enterocolitis, Pseudomembranous/diagnosis , Humans , MexicoABSTRACT
A multicenter open study aimed at evaluating the effect of famotidine in the treatment of duodenal ulcer was performed in several institutions located in 15 different cities of Mexico. One-hundred-and-fourteen patients with duodenal ulcer demonstrated by endoscopy were given 40 mg. of famotidine daily, administered as a single dose at night. After 4 and 6 weeks of treatment, healing of the ulcer was observed in 81.6% and 95.6% of patients, respectively. Side-effects were very unusual. In only one patient, who experienced vertigo during the treatment, administration of the drug had to be stopped.
Subject(s)
Anti-Ulcer Agents/therapeutic use , Duodenal Ulcer/drug therapy , Thiazoles/therapeutic use , Adolescent , Adult , Anti-Ulcer Agents/adverse effects , Drug Evaluation , Famotidine , Female , Humans , Male , Mexico , Middle Aged , Multicenter Studies as Topic , Thiazoles/adverse effectsABSTRACT
A multicentric open study designed to evaluate the effect of famotidine in the treatment of gastric ulcer was performed in several institutions located in 15 different cities of Mexico. 54 patients with gastric ulcer demonstrated by endoscopy were given 40 mg of famotidine daily, administered as a single dose at night. After 6 and 8 weeks of treatment, healing of the ulcer was observed in 63% and 88.9%, respectively. Side-effects were very unusual.
