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News

Clinical predictors of recurrent C. difficile infection in out-patients

The latest issue of the Alimentary Pharmacology & Therapeutics identifies clinical predictors of recurrent Clostridium difficile infection in out-patients.

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Clostridium difficile infection (CDI) recurs in 20–30% of patients.

Dr Pardi and colleagues from Minnesota, USA described the predictors of recurrence in out-patients with CDI.

Out-patient cases of CDI diagnosed between 2007 and 2010 were identified.

Recurrent CDI was defined as recurrence of diarrhoea with a positive C. difficile PCR test from 15 to 56 days after the initial diagnosis with interim resolution of symptoms.

The team excluded patients who had 2 positive tests within 14 days.

Concomitant antibiotic use was associated with risk of recurrent CDI
Alimentary Pharmacology & Therapeutics

Cox proportional hazard models were used to assess the association of clinical variables with time to recurrence of CDI.

The cohort included 520 out-patients, of which 104 had recurrent CDI.

The researchers identified increasing age and antibiotic use to be associated with recurrent CDI.

Severe CDI, peripheral leucocyte count and change in serum creatinine >1.5-fold were not.

On further analysis, the team found that concomitant antibiotic use was associated with risk of recurrent CDI.

Age, peripheral leucocyte count >15 × 109/L, and change in serum creatinine greater than 1.5-fold were not.

Dr Pardi's team concludes, "Antibiotic use was independently associated with a dramatic risk of recurrent Clostridium difficile infection in an out-patient cohort."

"It is important to avoid unnecessary systemic antibiotics in patients with Clostridium difficile infection, and patients with ongoing antibiotic use should be monitored closely for recurrent infection."

Aliment Pharmacol Ther 2014: 40(5): 518–522
28 August 2014

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