Impact of C. difficile Length of Treatment on Rates of Recurrence in Patients on Concurrent Antibiotics

Link to article at PubMed

Am J Infect Control. 2023 Apr 25:S0196-6553(23)00336-X. doi: 10.1016/j.ajic.2023.04.167. Online ahead of print.


BACKGROUND: Clostridioides difficile infection (CDI) is principally healthcare-associated with substantial impact on morbidity and mortality. Guidelines recommend CDI therapy for 10 days; however, it is often extended in practice when concurrent antibiotics are used. The impact of the extended duration of therapy remains unclear.

OBJECTIVE: To compare rates of CDI recurrence in patients receiving standard duration of therapy (SDT) compared to extended duration of therapy (EDT) for the treatment of hospital-acquired CDI (HA-CDI) while receiving concurrent antibiotics.

METHODS: A retrospective chart review was conducted between October 2017 and 2019. Adult HA - CDI patients who received a minimum 10 days of CDI therapy and were on concurrent antibiotics were stratified into SDT and EDT groups. Rates of CDI recurrence (at 90 and 180 days) and incidence of new onset vancomycin-resistant enterococcus (VRE) were compared.

RESULTS: 223 patients met the inclusion criteria (SDT - 106, EDT - 117). CDI recurrence rates at 90 and 180 days were not statistically significant between SDT and EDT groups (22% vs 26%, p = 0.40 and 26% vs 31%, p = 0.47). Although the incidence of VRE within the extended group was higher, it was not statistically significant (6% vs 9%, p = 0.29).

CONCLUSION: No significant difference in rates of recurrence or new onset VRE were observed between SDT and EDT in HA-CDI patients.

PMID:37105356 | DOI:10.1016/j.ajic.2023.04.167

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