Antibiotic Treatment of Hospitalized Patients with Pneumonia Complicated by Clostridium Difficile Infection

Abstract

Clostridium difficile infection (CDI) is one of the most common gastrointestinal complication after antimicrobial treatment. It is estimated that CDI after pneumonia treatment is connected with a higher mortality than other causes of hospitalization. The aim of the study was to assess the relationship between the kind of antibiotic used for pneumonia treatment and mortality from post-pneumonia CDI. We addressed the issue by examining retrospectively the records of 217 patients who met the diagnostic criteria of CDI. Ninety four of those patients (43.3 %) came down with CDI infection after pneumonia treatment. Fifty of the 94 patients went through severe or severe and complicated CDI. The distribution of antecedent antibiotic treatment of pneumonia in these 50 patients was as follows: ceftriaxone in 14 (28 %) cases, amoxicillin with clavulanate in 9 (18 %), ciprofloxacin in 8 (16.0 %), clarithromycin in 7 (14 %), and cefuroxime and imipenem in 6 (12 %) each. The findings revealed a borderline enhancement in the proportion of deaths due to CDI in the ceftriaxone group compared with the ciprofloxacin, cefuroxime, and imipenem groups. The corollary is that ceftriaxone should be shunned in pneumonia treatment. The study demonstrates an association between the use of a specific antibiotic for pneumonia treatment and post-pneumonia mortality in patients who developed CDI.

SYN-004 (ribaxamase), an oral beta-lactamase, mitigates antibiotic-mediated dysbiosis in a porcine gut microbiome model

“…; Zycinska et al . ) and VRE (Donskey et al . ), it is becoming apparent that total antibiotic exposure, including duration of therapy, and the dose utilized, are factors in secondary infection risk (Smits et al .…”

“…In North America and Europe, ceftriaxone (CRO) is the most frequently prescribed IV beta‐lactam (Arlington Medical Resources ) and has been linked to dysbiosis and increased risk of C. difficile infection (Slimings and Riley ; Crowther and Wilcox ; Zycinska et al . ). Notably, oral delivery of a beta‐lactamase isolated from Bacillus licheniformis , the PenP protein (Neugebauer et al .…”

Clostridioides difficile infection after pneumonia in elderly patients: which antibiotic is at lower risk?

“…Outcomes of patients with and without CDI are presented in table I. Hospitalization length is nearly twice longer in the CDI group (26 [18-38] vs 14 [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24], p < 0.001). Both in-hospital mortality (34% vs 20%, p = 0.009) and one-year mortality (63 % vs 42%, p = 0.002) were significantly higher after CDI.…”

“…AP is a leading cause of hospitalization in older patients and has been associated with a higher risk of CDI [13]. Several studies have assessed the association of antibiotics treatment for AP and CDI incidence [14][15][16]. However, to our knowledge, none have focused on a very elderly population.…”