Ronza Najjar-Debbiny1,2, Alina Bazazhina3, Naama Schwartz4, Pninit Shaked5, Walid Saliba6,7, Gabriel Weber8,6. 1. Infectious Diseases Unit, Lady Davis Carmel Medical Center, 7 Michal st, 34362, Haifa, Israel. Ronza.najjar@gmail.com. 2. Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. Ronza.najjar@gmail.com. 3. Internal Department B, Lady Davis Carmel Medical Center, Haifa, Israel. 4. School of Public Health, University of Haifa, Haifa, Israel. 5. Clinical Microbiology Lab, Lady Davis Carmel Medical Center, Haifa, Israel. 6. Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. 7. Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa, Israel. 8. Infectious Diseases Unit, Lady Davis Carmel Medical Center, 7 Michal st, 34362, Haifa, Israel.
Abstract
OBJECTIVES: We sought to assess the effectiveness of oral vancomycin compared to metronidazole on recurrence and mortality among hospitalized patients with non-severe Clostridioides difficile infection (CDI). METHODS: A single center retrospective cohort study was conducted, including adult patients hospitalized between 2015 and 2020 with a first episode of non-severe CDI, treated with metronidazole or vancomycin as monotherapy for at least 10 days. We assessed recurrence of CDI requiring hospitalization (primary outcome) and all-cause mortality up to 8 weeks, post discharge. RESULTS: Overall, 160 patients were treated with vancomycin and 149 treated with metronidazole. Re-hospitalization within 8 weeks due to CDI occurred in 10 (6.2%) patients in the vancomycin group, and 13 (8.7%) in the metronidazole group (P value = 0.407). Eight-week mortality occurred in 39 patients (26.2%) in the metronidazole group and 46 patients (28.8%) in the vancomycin group (P value = 0.61). After adjusting for age, gender, Ischemic heart disease, white blood cell count, neutrophile count and CRP, there was no significant difference between the two treatments (Re-hospitalization in 8 weeks due to CDI P = 0.5059; In-hospital death P = 0.7950; 4-week mortality P = 0.2988; 8-week mortality P = 0.8237). CONCLUSION: There is no benefit of using vancomycin compared to metronidazole concerning recurrence rate requiring hospitalization, in-hospital and up to 4- and 8-week mortality rate in non-severe first episode of CDI.
OBJECTIVES: We sought to assess the effectiveness of oral vancomycin compared to metronidazole on recurrence and mortality among hospitalized patients with non-severe Clostridioides difficile infection (CDI). METHODS: A single center retrospective cohort study was conducted, including adult patients hospitalized between 2015 and 2020 with a first episode of non-severe CDI, treated with metronidazole or vancomycin as monotherapy for at least 10 days. We assessed recurrence of CDI requiring hospitalization (primary outcome) and all-cause mortality up to 8 weeks, post discharge. RESULTS: Overall, 160 patients were treated with vancomycin and 149 treated with metronidazole. Re-hospitalization within 8 weeks due to CDI occurred in 10 (6.2%) patients in the vancomycin group, and 13 (8.7%) in the metronidazole group (P value = 0.407). Eight-week mortality occurred in 39 patients (26.2%) in the metronidazole group and 46 patients (28.8%) in the vancomycin group (P value = 0.61). After adjusting for age, gender, Ischemic heart disease, white blood cell count, neutrophile count and CRP, there was no significant difference between the two treatments (Re-hospitalization in 8 weeks due to CDI P = 0.5059; In-hospital death P = 0.7950; 4-week mortality P = 0.2988; 8-week mortality P = 0.8237). CONCLUSION: There is no benefit of using vancomycin compared to metronidazole concerning recurrence rate requiring hospitalization, in-hospital and up to 4- and 8-week mortality rate in non-severe first episode of CDI.
Authors: L Clifford McDonald; Dale N Gerding; Stuart Johnson; Johan S Bakken; Karen C Carroll; Susan E Coffin; Erik R Dubberke; Kevin W Garey; Carolyn V Gould; Ciaran Kelly; Vivian Loo; Julia Shaklee Sammons; Thomas J Sandora; Mark H Wilcox Journal: Clin Infect Dis Date: 2018-03-19 Impact factor: 9.079
Authors: Anthony T Podany; Michelle Pham; Erin Sizemore; Neil Martinson; Wadzanai Samaneka; Lerato Mohapi; Sharlaa Badal-Faesen; Rod Dawson; John L Johnson; Harriet Mayanja; Umesh Lalloo; William C Whitworth; April Pettit; Kayla Campbell; Patrick P J Phillips; Kia Bryant; Nigel Scott; Andrew Vernon; Ekaterina V Kurbatova; Richard E Chaisson; Susan E Dorman; Payam Nahid; Susan Swindells; Kelly E Dooley; Courtney V Fletcher Journal: Clin Infect Dis Date: 2022-09-10 Impact factor: 20.999