Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
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.
To comparethe CDI recurrence rates of metronidazole/vancomycin combination therapy to oral vancomycin monotherapy in SOT recipients following a first episode of uncomplicated CDI.
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.
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|
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 December 5, 2019.
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