Outcomes associated with recent guideline recommendations removing metronidazole for treatment of non-severe Clostridioides difficile infection: a retrospective, observational, nationwide cohort study.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read More Add to Saved list
  • Additional Information
    • Source:
      Publisher: Elsevier Science Publishers Country of Publication: Netherlands NLM ID: 9111860 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-7913 (Electronic) Linking ISSN: 09248579 NLM ISO Abbreviation: Int J Antimicrob Agents Subsets: MEDLINE
    • Publication Information:
      Original Publication: Amsterdam : Elsevier Science Publishers, c1991-
    • Subject Terms:
      Clostridium Infections/*drug therapy ; Clostridium Infections/*mortality ; Fidaxomicin/*therapeutic use ; Metronidazole/*therapeutic use ; Vancomycin/*therapeutic use; Aged ; Anti-Bacterial Agents/therapeutic use ; Clostridioides difficile/drug effects ; Drug Utilization/standards ; Female ; Humans ; Male ; Middle Aged ; Practice Guidelines as Topic ; Recurrence ; Retrospective Studies ; Risk Factors ; Treatment Outcome
    • Abstract:
      Objectives: The 2017 Society for Healthcare Epidemiology of America (SHEA) and Infectious Diseases Society of America (IDSA) Clinical Practice Guidelines for Clostridioides difficile (C. difficile) infection (CDI) removed metronidazole as a preferred option for initial episodes of non-severe CDI. This study aimed to determine if the shift away from metronidazole improved clinical outcomes of initial episodes of non-severe CDI.
      Methods: The study was a retrospective, observational, nationwide cohort study using a Veterans Health Administration national clinical administrative database. Adult patients treated for non-severe CDI before and after the February 2018 publication of the 2017 IDSA/SHEA C. difficile Clinical Practice Guidelines were included. The primary outcome was the composite of treatment failure or probable recurrence.
      Results: A total of 3608 patients were included, with 1809 in the pre-guideline cohort (mean [SD] age, 65.5 [14.2] years; 1602 [88.6%] male) and 1799 in the post-guideline cohort (mean [SD] age, 64 [14.6] years; 1584 [88%] male). Overall composite of treatment failure or probable recurrence was similar between both cohorts (318 of 1809 [17.6%] pre-guideline cohort vs. 317 of 1799 [17.6%] post-guideline cohort [P = 0.97]).
      Conclusion: The shift away from metronidazole as a preferred option in initial non-severe Clostridioides difficile infection did not improve the composite of treatment failure or recurrence.
      (Published by Elsevier Ltd.)
    • Contributed Indexing:
      Keywords: Clostridioides difficile infection; Metronidazole; Vancomycin
    • Accession Number:
      0 (Anti-Bacterial Agents)
      140QMO216E (Metronidazole)
      6Q205EH1VU (Vancomycin)
      Z5N076G8YQ (Fidaxomicin)
    • Publication Date:
      Date Created: 20210119 Date Completed: 20210913 Latest Revision: 20210913
    • Publication Date:
      20231215
    • Accession Number:
      10.1016/j.ijantimicag.2021.106282
    • Accession Number:
      33465458