Recurrent CDAD Overall, ~15–30% of patients experience recurrences of CDAD, either as relapses caused by the original organism or as reinfections following treatment (Table 123-2). Recurrence rates are higher among patients ≥65 years old and among patients who remain in the hospital after the initial episode of CDAD. Patients who have a first recurrence of CDAD have a high rate of second recurrence (33–65%). In the first recurrence, re-treatment with metronidazole is comparable to treatment with vancomycin. Recurrent disease, once thought to be relatively mild, has been documented to pose a significant (11%) risk of serious complications (shock, megacolon,.
