Perbandingan Efektivitas Vancomycin versus Metronidazole pada Terapi Infeksi Clostridioides difficile (Narrative Review)

Clostridioides difficile infection (CDI) causes diarrhea and inflammation of the large intestine (colitis), with a high morbidity and mortality rate, making it necessary to consider appropriate and effective treatment. Metronidazole and vancomycin are the two most commonly used antibiotics for the treatment of CDI and have different clinical outcomes. This review assesses the comparative effectiveness of vancomycin and metronidazole on recurrence and mortality. Cohort studies were included in this literature review following the PRISMA checklist and using the ScienceDirect, PubMed, and JAMA databases with the keywords “Vancomycin, Metronidazole, Clostridioides difficile, Effectiveness, and Infection.” The results of the review of 5 cohort journals showed that both metronidazole and vancomycin have similar effectiveness in treating Clostridioides difficile infection (CDI), with no significant differences in clinical response, recurrence, and mortality. However, vancomycin showed a slight advantage in the treatment of patients with severe CDI, including reducing the risk of death within 30 days. In general, both treatments can be considered equivalent in the treatment of CDI in hospitalized patients.