Oral Vancomycin Monotherapy versus Combination Therapy in Solid Organ Transplant Recipients with Uncomplicated Clostridium difficile Infection: A Retrospective Cohort Study
1Department of Pharmaceutical Practices, Princess Nourah Bint Abdulrahman University, Riyadh, NA, Saudi Arabia
2Department of Pharmacy Practice and Science, University of Arizona, Tucson, AZ
3Department of Clinical Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
4Banner - University Medical Center Tucson, Tucson, AZ
5Division of Infectious Diseases, Department of Medicine, University of Arizona, Tucson, AZ.
Meeting: 2018 American Transplant Congress
Abstract number: D169
Session Information
Session Name: Poster Session D: Kidney Infectious
Session Type: Poster Session
Date: Tuesday, June 5, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Introduction:
Solid organ transplant (SOT) recipients are at high risk of Clostridium difficile infection (CDI) and CDI recurrence. A combination of metronidazole and oral vancomycin is often prescribed for SOT recipients with uncomplicated CDI despite any clinical practice guidelines supporting the need for combination therapy.
Objectives:
To comparethe CDI recurrence rates of metronidazole/vancomycin combination therapy to oral vancomycin monotherapy in SOT recipients following a first episode of uncomplicated CDI.
Methods:
A single-center retrospective cohort study evaluated SOT recipients diagnosed with uncomplicated CDI who were treated with vancomycin monotherapy or vancomycin/ metronidazole combination therapy. The primary end-point was CDI recurrence defined as a second CDI episode within 8 weeks of completing index CDI therapy. The secondary endpoints were timebetween the end of CDI therapy and recurrence.
Results:
Fifteen patients (25%) of 61 subjects experienced CDI recurrence. There was no statistically significant difference in CDI recurrence rate between the vancomycin monotherapy group and combination therapy group (23% versus 27%, respectively; p=0.715). The median total length of hospitalization between the 2 groups was statistically significant ( 9 versus 14 days, respectively; p=0.047)-
| Study Endpoints | Oral vancomycin monotherapy (N=35) | Combination therapy (N=26) | P-value |
| CDI recurrence, N (%) | 8 (23) | 7 (27) | 0.715 |
| Time between end of CDI therapy and recurrence in days, median [IQR] | 27 [9-46] | 21 [15-22] | 0.643 |
| Total length of hospitalization in days, median [IQR] | 9 [5-19] | 14 [6-23] | 0.047 |
| Length of hospitalization after CDI diagnosis in days, median [IQR] | 4 [3-9] | 10 [6-22] | 0.214 |
Conclusion:
There was no difference found in recurrence rate between oral vancomycin monotherapy versus combination therapy.
CITATION INFORMATION: Korayem G., Eljaaly K., Matthias K., Zangeneh T. Oral Vancomycin Monotherapy versus Combination Therapy in Solid Organ Transplant Recipients with Uncomplicated Clostridium difficile Infection: A Retrospective Cohort Study Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Korayem G, Eljaaly K, Matthias K, Zangeneh T. Oral Vancomycin Monotherapy versus Combination Therapy in Solid Organ Transplant Recipients with Uncomplicated Clostridium difficile Infection: A Retrospective Cohort Study [abstract]. https://atcmeetingabstracts.com/abstract/oral-vancomycin-monotherapy-versus-combination-therapy-in-solid-organ-transplant-recipients-with-uncomplicated-clostridium-difficile-infection-a-retrospective-cohort-study/. Accessed May 16, 2025.« Back to 2018 American Transplant Congress