Comparing Antibiotics for Clostridium Difficile in IBD Patients
the MPR take:
Patients with inflammatory bowel disease (IBD) including ulcerative colitis (UC) and Crohn's disease (CD) tend to have worse outcomes when it comes to treatment for Clostridium difficile infection (CDI), but a new study suggests that a regimen with oral vancomycin could lead to fewer readmissions and shorter lengths of hospital stays compared to metronidazole. This retrospective observational study of 114 patients with UC and CD admitted for CDI from January 2006 to December 2010 assessed CDI severity, readmission for CDI within 30 days and 12 weeks, length of stay, colectomy, and death. UC patients with nonsevere CDI had fewer readmissions and shorter lengths of stay with a vancomycin-containing regimen vs. those treated with metronidazole. Although metronidazole is the current standard of care for nonsevere CDI and vancomycin for severe CDI, the authors recommend that patients with UC and CDI should be treated with vancomycin for optimal treatment results.
Patients with inflammatory bowel disease (IBD), namely ulcerative colitis (UC) and Crohn's disease (CD), have worse outcomes with Clostridium difficile infection (CDI), including increased readmissions, colectomy, and death. Oral vancomycin is recommended for the treatment of severe CDI, while metronidazole is the standard of care for nonsevere infection.