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

Archimandritis A, Souyioultzis S, Katsorida M, Tzivras M (University of Athens Medical School, Laiko General Hospital, Athens, Greece). Clostridium difficile colitis associated with a ‘triple’ regimen, containing clarithromycin and metronidazole, to eradicate Helicobacter pylori (Case Report). J Intern Med 1998; 243 : 251–53. 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.