Evaluation of Rectal Vancomycin Irrigation for Treatment of<i>Clostridioides difficile</i>Infection in Patients Post-Colectomy for Toxic Colitis

Feeney, Megan; Thompson, Molly; Gerlach, Anthony T.; Rushing, Amy P.; Evans, David C.; Eiferman, Daniel; Murphy, Claire V.

doi:10.1089/sur.2018.265

Cited by 3 publications

(9 citation statements)

References 8 publications

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“…1). [11][12][13][14][15][16][17][18][19][20][21][22][23][24] Of the eligible 14 studies, 6 were RCTs and 8 were observational controlled studies with 5 being retrospective (Table 1). The total studies enrolled 1324 patients (372 patients in RCTs and 952 patients in observational studies).…”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies with a total of 1046 patients were included for the meta-analysis of the outcome of clinical response and cure 12–17,19–24 . There were 5 RCTs and 7 observational studies (262 and 784 participants, respectively).…”

Section: Resultsmentioning

confidence: 99%

“…The total studies enrolled 1324 patients (372 patients in RCTs and 952 patients in observational studies). A total of 9 studies, 3 randomized and 6 observational, were rated as “low risk” and 5, 3 randomized and 2 observational, were rated as “high risk.” Ten different CDI treatment regimens were investigated in these comparative studies: high-dose oral vancomycin, high-dose rectal vancomycin, standard-dose oral vancomycin, oral and intravenous metronidazole, bacitracin, teicoplanin, fusidic acid, fecal transplantation, and fidaxomicin 11–24 …”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies with a total of 1046 patients were included for the meta-analysis of the outcome of clinical response and cure. [12][13][14][15][16][17][19][20][21][22][23][24] There were 5 RCTs and 7 observational studies (262 and 784 participants, respectively). There was no statistically significant effect on clinical cure/ response (OR, 0.70; 95% CI, 0.34-1.43; I 2 = 59%; Fig.…”

Section: Clinical Response and Curementioning

confidence: 99%

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High-Dose Vancomycin in the Treatment of Clostridioides difficile Infection

Bader

Mertz

Hawboldt³

et al. 2022

Infect Dis Clin Pract

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BackgroundThere is significant variability in guideline recommendations regarding the dosing of vancomycin in treating Clostridioides difficile infection (CDI). The aim of this systematic review and meta-analysis was to investigate the efficacy of high-dose vancomycin compared with other current standard of care and other CDI treatment regimens.MethodsWe conducted a comprehensive literature search in PubMed, the Cochrane Library, Embase, and Web of Science for publications that studied the comparative effectiveness of high-dose vancomycin to other CDI treatment regimens for the period up to July 2020.ResultsA total of 14 studies, 6 randomized controlled trials (372 participants) and 8 observational controlled studies (952 participants), with a total of 1324 patients were included in the final analysis. There was no statistically significant effect between high-dose vancomycin and other treatment options of CDI on clinical cure/response (odd ratio [OR], 0.70; 95% confidence interval [CI], 0.34 to 1.43; I2 = 59%), clinical relapse and recurrence (OR, 1.01; 95% CI, 0.72–1.42; I2 = 61%), and mortality (OR, 1.03; 95% CI, 0.37–2.84; I2 = 44%).ConclusionsHigh-dose oral vancomycin was not superior to other treatment regimens for the outcomes of clinical response and cure, recurrence, and mortality of CDI.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Clinical Response and Curementioning

confidence: 99%

See 2 more Smart Citations

High-Dose Vancomycin in the Treatment of Clostridioides difficile Infection

Bader

Mertz

Hawboldt³

et al. 2022

Infect Dis Clin Pract

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“…The infection parameters included the site, type, and severity of infection. Adverse clinical outcomes included transfer to the intensive care unit (ICU) and/or death [22].…”

Section: Data Collectionmentioning

confidence: 99%

Infection-related hospitalization after intensive immunosuppressive therapy among lupus nephritis and ANCA glomerulonephritis patients

Yin

Wen

et al. 2020

Renal Failure

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Introduction: This study aimed to investigate the clinical characteristics, risk factors, and outcomes of infection-related hospitalization (IRH) in patients with lupus nephritis (LN) and ANCA glomerulonephritis after intensive immunosuppressive therapy. Methods: Patients diagnosed with LN or ANCA glomerulonephritis who received intensive immunosuppressive therapy at the First Affiliated Hospital of Sun Yat-sen University from 2005 to 2014 were enrolled. Demographics, laboratory parameters, immunosuppressive agents, and IRH details were collected. Multivariable Cox regression was used, and hazard ratios (HRs) and 95% confidence intervals (CIs) were reported. Results: Totally, 872 patients with 806 LN and 66 ANCA glomerulonephritis were enrolled, and 304 (34.9%) patients with 433 episodes of IRH were recorded. ANCA glomerulonephritis patients were more vulnerable to IRH than LN patients (53.0% vs. 33.4%, p ¼ .001). Multivariable Cox regression analysis showed that ANCA glomerulonephritis (HR ¼ 1.62, 95% CI: 1.06-2.49, p ¼ .027), diabetes (HR ¼ 1.82, 95% CI: 1.03-3.22, p ¼ .039) and a higher initial dose of prednisone (HR ¼ 1.01, 95% CI: 1.00-1.02, p ¼ .013) were associated with a higher likelihood of IRH. Higher albumin (HR ¼ 0.96, 95% CI: 0.94-0.98, p < .001), globulin (HR ¼ 0.98, 95% CI: 0.96-0.99, p ¼ .008), and eGFR (HR ¼ 0.99, 95% CI: 0.99-1.00, p < .001), were associated with a lower likelihood of IRH. The rates of transfer to ICU and mortality for ANCA glomerulonephritis patients were higher than those for LN patients (22.9% vs. 1.9%, p < .001, and 20.0% vs. 0.7%, p < .001, respectively). Conclusions: ANCA glomerulonephritis patients had a higher risk of IRH and poorer outcome once infected after intensive immunosuppressive therapy than LN patients. More strict control for infection risks is required for ANCA glomerulonephritis patients who undergo intensive immunosuppressive therapy.

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