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International Journal of Clinical Oncology

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01-12-2018 | Original Article

Observational study of chemotherapy-induced Clostridium difficile infection in patients with lung cancer

Authors: Yukihiro Toi, Shunichi Sugawara, Takao Kobayashi, Keisuke Terayama, Yoshihiro Honda

Published in: International Journal of Clinical Oncology | Issue 6/2018

Abstract

Background

Diarrhea post-antibiotic use is primarily attributed to Clostridium difficile infection (CDI)-induced mucosal lesions, and evidence of CDI in patients undergoing chemotherapy without prior antibiotic treatment is also increasing. However, few studies have investigated the relationship between chemotherapy use and diarrhea. This study aimed to determine whether the incidence of CDI increased in patients with lung cancer undergoing chemotherapy even without prior antibiotic treatment.

Methods

We conducted a retrospective study and investigated the presence of Clostridium difficile (C. difficile) and its toxins in patients who experience diarrhea during chemotherapy. If grade 2 or higher diarrhea was noted, a stool culture was performed to detect anaerobic organisms and C. difficile toxins A and B.

Results

A total of 345 consecutive patients (492 in terms of chemotherapy regimens) were enrolled in the study. Grade 2 or higher diarrhea was observed in patients using 36 (7.3%) of these regimens, among which CDI without prior antibiotic exposure was confirmed in patients using 8 regimens (22.2%).

Conclusions

CDI may remain undetected in patients undergoing chemotherapy even in those who had not received antibiotic treatment previously, unless due attention is paid to its possibility. Testing for C. difficile toxins is highly recommended to expedite timely treatment for diarrhea in such patients. Further studies are needed to clarify the relationship between chemotherapy drug use and CDI to facilitate prevention.

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Title: Observational study of chemotherapy-induced Clostridium difficile infection in patients with lung cancer
Authors: Yukihiro Toi
Shunichi Sugawara
Takao Kobayashi
Keisuke Terayama
Yoshihiro Honda
Publication date: 01-12-2018
Publisher: Springer Japan
Published in: International Journal of Clinical Oncology / Issue 6/2018
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-018-1304-5

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Abstract

Background

Methods

Results

Conclusions

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