DIFFICILE IN PATIENTS TREATED WITH VARIOU S ANTIBIOTICS FOR THERAPEUTIC REASONS OR WITH CEFOXITIN AS PERIOPERATIVE PROPHYLAXIS

Clostridium difficile and/or toxin B were isolated from the faeces of 3 (1.6%) of 184 patients within the first two days of hospitalisation in the University of Tubingen, Gynaecological Clinic. With following s tool samples from a total of 117 patients the isolation rate of C. dif ficile was examined in relation to the treatment with antibiotics. Fro m the first group of 61 patients, who had had gynaecological operation s and were not treated with any antibiotic, the isolation rate of C. d ifficile rose statistically but not significantly from 0% at the time of admission up to 3.3% during hospitalisation. Amongst the second gro up of 17 patients, who had had gynaecological operations and were trea ted with various antibiotics for at least three days, the isolation ra te was also found to rise insignificantly from 0 to 11.8% (p < 0.1). T he third group of 33 patients, who had had gynaecological operations a nd perioperative prophylaxis with cefoxitin (one to three doses 2 g ea ch), the isolation rate rose significantly from 0 to 12.1% (p < 0.05). The result of this study shows that the bacterial flora of the gut wa s probably altered even after a very brief application of cefoxitin. I n two environmental examinations on the wards of the patients of this study, C. difficile was not isolated in any case.