Mo1656 Outcomes of Fidaxomicin Treatment of Clostridium difficile Infection

Spiceland, Clayton M.; Saffouri, George; Pardi, Darrell S.; Khanna, Sahil

doi:10.1016/s0016-5085(16)32527-6

Cited by 3 publications

(2 citation statements)

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“…The rate of recurrent CDI was 19% with a median time to recurrence of 29 days. 50 The high upfront cost of fidaxomicin therapy has curtailed its widespread use, but cost-ef- fectiveness studies have shown a benefit to due to further recurrence prevention. 51 The risk of recurrent CDI after a first infection in non-IBD patients is 20%-30% and is about 33%-50% higher in patients who have IBD, despite the absence of risk factors other than IBD such as antibiotic exposure.…”

Section: Vancomycin or Fidaxomicin But Not Metronidazolementioning

confidence: 99%

“…A retrospective study evaluated fidaxomicin use in 21 IBD patients who had CDI and demonstrated that all patients responded either with symptom improvement or a negative C. difficile test. The rate of recurrent CDI was 19% with a median time to recurrence of 29 days [ 50 ]. The high upfront cost of fidaxomicin therapy has curtailed its widespread use, but cost-effectiveness studies have shown a benefit to due to further recurrence prevention [ 51 ].…”

Section: Medical Treatment Of CDI In Ibdmentioning

confidence: 99%

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Management of Clostridioides difficile infection in patients with inflammatory bowel disease

Khanna

2021

Intest Res

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tered gut microbiota is colonization and infection with opportunistic microorganisms such as Clostridioides difficile. Studies over the years have demonstrated that the commonest infectious complication and the leading cause of a disease flareup in patients with IBD is C. difficile infection (CDI). 3 In contrast, non-C. difficile bacterial infections are uncommon in IBD patients with a disease flare. 4 Clostridioides difficile (formerly Clostridium difficile also known as C. difficile or C. diff) is an anaerobic Gram-positive spore forming bacterium that is ubiquitous in our environment. 5 Exposure to the C. difficile bacterium (spore or vegetative form) can lead to spectrum of outcomes ranging from no effect and no colonization to asymptomatic colonization to mild-moderate illness to severe diarrhea to fulminant lifethreatening infection. 6 It is now well-recognized that IBD patients are at a high risk of developing CDI even in the absence of other traditional risk factors. 3 In 2017, the American Gastroenterological Association released an expert clinical practice

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Section: Vancomycin or Fidaxomicin But Not Metronidazolementioning

confidence: 99%

Section: Medical Treatment Of CDI In Ibdmentioning

confidence: 99%

Management of Clostridioides difficile infection in patients with inflammatory bowel disease

Khanna

2021

Intest Res

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Management of Clostridium difficile Infection in Inflammatory Bowel Disease: Expert Review from the Clinical Practice Updates Committee of the AGA Institute

Khanna

Shin

Kelly

2017

Clinical Gastroenterology and Hepatology

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The purpose of this expert review is to synthesize the existing evidence on the management of Clostridium difficile infection in patients with underlying inflammatory bowel disease. The evidence reviewed in this article is a summation of relevant scientific publications, expert opinion statements, and current practice guidelines. This review is a summary of expert opinion in the field without a formal systematic review of evidence. Best Practice Advice 1: Clinicians should test patients who present with a flare of underlying inflammatory bowel disease for Clostridium difficile infection. Best Practice Advice 2: Clinicians should screen for recurrent C difficile infection if diarrhea or other symptoms of colitis persist or return after antibiotic treatment for C difficile infection. Best Practice Advice 3: Clinicians should consider treating C difficile infection in inflammatory bowel disease patients with vancomycin instead of metronidazole. Best Practice Advice 4: Clinicians strongly should consider hospitalization for close monitoring and aggressive management for inflammatory bowel disease patients with C difficile infection who have profuse diarrhea, severe abdominal pain, a markedly increased peripheral blood leukocyte count, or other evidence of sepsis. Best Practice Advice 5: Clinicians may postpone escalation of steroids and other immunosuppression agents during acute C difficile infection until therapy for C difficile infection has been initiated. However, the decision to withhold or continue immunosuppression in inflammatory bowel disease patients with C difficile infection should be individualized because there is insufficient existing robust literature on which to develop firm recommendations. Best Practice Advice 6: Clinicians should offer a referral for fecal microbiota transplantation to inflammatory bowel disease patients with recurrent C difficile infection.

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Review of updated clinical practice guidelines of the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) for Clostridium difficile infection in adults and children (2017)

Kozlov

Shelygin

Веселов

et al. 2018

CMAC

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An update on 2010 clinical practice guideline on Clostridium difficile infection (CDI) by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) was published in March 2018. This new version of guideline not only includes significant changes in the management of this infection and reflects the evolving controversy over best methods for diagnosis and threatment of CDI but has also incorporated recommendations for children. This document currently is the most complete and up to date source of information on CDI. In the present article we reviewed this new IDSA/SHEA guideline and compared it with existing European and Russian guidelines.

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Mo1656 Outcomes of Fidaxomicin Treatment of Clostridium difficile Infection

Cited by 3 publications

References 0 publications

Management of Clostridioides difficile infection in patients with inflammatory bowel disease

Management of Clostridioides difficile infection in patients with inflammatory bowel disease

Management of Clostridium difficile Infection in Inflammatory Bowel Disease: Expert Review from the Clinical Practice Updates Committee of the AGA Institute

Review of updated clinical practice guidelines of the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) for Clostridium difficile infection in adults and children (2017)

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