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In a prospective observational study published in 2005, Musher and associates examined treatment outcomes in all patients treated for C. Of 207 patients, 46 (22) had persistent symptoms after 10 days of treatment with at least 1. 5 g daily of oral metronidazole, a finding that contrasted sharply with a 1994 study from a different VA, in which 97 of 632 patients responded to metronidazole.
11 This decreased response to metronidazole likely reflects increased severity of disease. In a 2005 editorial, Gerding recommends that the switch to vancomycin also be considered in patients whose leukocytosis worsens during therapy.