Patients admitted to an ICU for Clostridium difficile infection were at risk for developing subsequent C. difficile infections, according to recent research.
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Patients with Clostridium difficile infection (CDI) warranting admission to the ICU may benefit from a treatment regimen of combined oral vancomycin and IV metronidazole, according to recent findings.
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In a retrospective, observational, comparative study, researchers evaluated 88 critically ill adult patients with C. difficile who were admitted to the ICU at Wake Forest Baptist Medical Center between June 2007 and September 2012. All patients were treated for CDI with oral vancomycin, and those in the combination therapy group received concomitant metronidazole intravenously for a minimum of 72 hours. Patients were matched and equally placed within either the combination or vancomycin-only groups using the Acute Physiology and Chronic Health Evaluation II (APACHE II) metric. The patients were clinically and demographically comparable, although the combination therapy group had a higher prevalence of moderate-to-severe renal disease.
The study’s primary outcome was in-hospital death, and secondary outcomes included clinical success at days 6, 10 and 21; hospital length of stay after diagnosis of CDI; and duration of ICU stay after diagnosis of CDI. Multivariable analysis was used to identify factors independently correlated with survival.