Miguel Salazar1, Kevin W Garey2, Zhi-Dong Jiang3, Thanh Dao-Tran1, Herbert DuPont3. 1. St. Luke's Episcopal Hospital, Houston, TX, 77030, USA. 2. University of Houston College of Pharmacy, Houston, TX, 77030, USA. kgarey@uh.edu. 3. University of Texas School of Public Health, Houston, TX, 77030, USA.
Abstract
OBJECTIVE: To assess changes in testing and treatment trends of CDI at a time when the Clostridium difficile hypervirulent strain was first identified. METHOD: A retrospective cohort study was performed. C. difficile cytotoxicity results were merged with pharmacy databases and changes in testing and treatment pattern over time were assessed. RESULTS: 6,613 tests for C. difficile were performed on 5,100 patients. Using least squares regression times series analysis, rates of testing increased by 0.63 +/- 0.31 tests per month (P = 0.05) although the number of positive tests did not increase significantly. Overall, metronidazole was the most commonly used drug (81.6%), followed by vancomycin (9.3%), rifaximin (8.4%), and nitazoxanide (0.70%). Use of rifaximin increased by 3.3 +/- 0.55 new prescriptions per month (Fig. 2; P < 0.01) while use of metronidazole increased by 5.0 +/- 2.8 new prescriptions per month and oral vancomycin increased by 0.4 +/- 0.7 new prescriptions per month; however these results were not statistically significant. For patients receiving rifaximin the drug was given as monotherapy (26.2%), in combination with oral vancomycin (24.2%), or in combination with metronidazole (49.7%). CONCLUSION: Increased rates of CDI testing and use of alternative therapies was observed at a time when the hypervirulent strain was first identified.
OBJECTIVE: To assess changes in testing and treatment trends of CDI at a time when the Clostridium difficile hypervirulent strain was first identified. METHOD: A retrospective cohort study was performed. C. difficilecytotoxicity results were merged with pharmacy databases and changes in testing and treatment pattern over time were assessed. RESULTS: 6,613 tests for C. difficile were performed on 5,100 patients. Using least squares regression times series analysis, rates of testing increased by 0.63 +/- 0.31 tests per month (P = 0.05) although the number of positive tests did not increase significantly. Overall, metronidazole was the most commonly used drug (81.6%), followed by vancomycin (9.3%), rifaximin (8.4%), and nitazoxanide (0.70%). Use of rifaximin increased by 3.3 +/- 0.55 new prescriptions per month (Fig. 2; P < 0.01) while use of metronidazole increased by 5.0 +/- 2.8 new prescriptions per month and oral vancomycin increased by 0.4 +/- 0.7 new prescriptions per month; however these results were not statistically significant. For patients receiving rifaximin the drug was given as monotherapy (26.2%), in combination with oral vancomycin (24.2%), or in combination with metronidazole (49.7%). CONCLUSION: Increased rates of CDI testing and use of alternative therapies was observed at a time when the hypervirulent strain was first identified.
Authors: Kevin W Garey; Gail Graham; Laura Gerard; Thanh Dao; Zhi Dong Jiang; Margaret Price; Herbert L Dupont Journal: Ann Pharmacother Date: 2006-05-09 Impact factor: 3.154
Authors: Amelia K Sofjan; Mohammad Aminul Islam; Kakali Halder; Nayel D Kabir; Ahmed Abu Saleh; Julie Miranda; Chris Lancaster; Khurshida Begum; M Jahangir Alam; Kevin W Garey Journal: Anaerobe Date: 2019-07-26 Impact factor: 3.331
Authors: Vy P Pham; Andrea M Luce; Sara C Ruppelt; Wenjing Wei; Samuel L Aitken; William L Musick; Ryan K Roux; Kevin W Garey Journal: Antimicrob Agents Chemother Date: 2015-07-20 Impact factor: 5.191