Infectious Disease

According to study results, the choice of antibiotics influences the excretion of C. difficile and the contamination in the hospital

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Turner does not report any relevant financial information. Please refer to the study for all relevant financial information from the other authors.

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Fidaxomicin and vancomycin reduced the excretion of Clostridioides difficile spores more quickly and, according to study results, were associated with lower hospital contamination compared to metronidazole.

“A unique facet of infectious diseases is the infectious part. How we treat our patients is not only important for their own health, but also for those around them. ” Nicholas Turner, MD, MHSc, Assistant professor of medicine in the Infectious Disease Department at Duke University Medical Center, Healio said.

C. diff infographic

Source: Turner NA, et al. Clin Infect Dis. 2021; doi: 10.1093 / cid / ciab473.

“After seeing different clinical response rates to C. difficile treatments, we began to wonder whether the choice of treatment affects not only rapid recovery but also the risk of transmission within the hospital,” said Turner.

Turner and colleagues conducted a prospective, open-label, randomized controlled study in hospitalized adults with C. difficile infection in which subjects were randomly given 1: 1: 1 fidaxomicin, oral vancomycin, or metronidazole.

Nicholas Turner

Of the 33 patients included in the study, 31 completed it. In these patients, the researchers found that fidaxomicin and vancomycin were associated with faster decreases in C. difficile excretion compared to metronidazole. In addition, both vancomycin (6.3%; 95% CI, 4.7% -8.3%) and fidaxomicin (13.1%; 95% CI, 10.7-15.9%) were included lower environmental contamination rates than metronidazole (21.4%; 95%). KI, 18% -25.2%).

When researchers performed specific modeling to assess subject change over time, fidaxomicin (adjusted OR = 0.83; 95% CI 0.7-0.99) was associated with a faster decrease in pollution than vancomycin or metronidazole.

“Treatment decisions for C. difficile can affect not only your patient but the next person to occupy the room,” said Turner. “By reducing hair loss and room contamination, vancomycin or fidaxomicin can play a role in reducing C. difficile rates in healthcare.”

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