Clostridium difficile colitis associated with a 'triple' regimen, containing clarithromycin and metronidazole, to eradicate Helicobacter pylori

Abstract

We describe a 54-year-old man with Helicobacter pylori (+) duodenal ulcer who developed Clostridium difficile associated colitis, 5 days after commencing a 'triple' regimen consisting of omeprazole 20 mg b.d., metronidazole 500 mg b.d. and clarithromycin 500 mg b.d., to eradicate H. pylori. Despite the fact that oral metronidazole did not prevent the disease, the patient did well after treatment with oral metronidazole plus a yeast preparation (Saccharomyces bulardii). No relapse occurred.