Tag Archives: rCDI Recurrenct C.diff. Infection

Microbiota Restoration in Recurrent C. difficile and COVID-19 : Sponsored by ACHL Academy for Continued Healthcare Learning Activity

Microbiota Restoration in Recurrent C. difficile (C. diff. ) and COVID-19

Intended Audience

This activity is intended for gastroenterologists, infectious disease specialists, and other clinicians who care for patients at risk of serious infection.

Activity Purpose: While the incidence of multiply recurrent C. difficile continues to rise, FMT has emerged as a means to break the cycle. Amid the current COVID-19 pandemic, clinicians should be aware of the additional safety concerns that have arisen. Expert faculty will discuss approaches to FMT including sourcing and screening of donor stool, which requires heightened safety measures during the COVID-19 pandemic. This activity is the first in a series of two educational activities that address the latest data on treating patients who experience rCDI.

Please click on the following link to be redirected to the activity

(Expires on September 6, 2020)

https://www.achlcme.org/COVID-19-MicrobiotaRestoration

Researchers Share Risk Factors for Recurrence of Clostridioides difficile (formally known as Clostridium difficile) Infection In Japan Real-World Analysis

Author information

Kimura T¹, Snijder R², Sugitani T³.

Abstract

OBJECTIVE:

Recurrent Clostridioides (Clostridium) difficile infection (rCDI) is common and increases healthcare resource utilization. In this study, we assessed rCDI risk factors using an up-to-date, Japanese national hospital-based database.

METHODS:

C. difficile infection (CDI) episodes, occurring July 2014-June 2017, in patients aged ≥18 years were extracted from the database and a nested case-control analysis was performed. Cases were defined as rCDI episodes which required re-initiation of oral vancomycin or oral/intravenous metronidazole treatment within 8 weeks from the start of initial treatment. Cases were matched to 4 non-rCDI episodes at the timing of rCDI occurrence. Adjusted odds ratios (ORs) were estimated using multivariate conditional logistic regression model.

RESULTS:

Of 18,246 initial CDI episodes, 3250 (17.8%) had at least one rCDI. Approximately 90% of episodes occurred in inpatients and 65% were treated with metronidazole. Older age (<75 years vs 75-84 years and vs 85 + years) was associated with higher risk of rCDI (OR = 1.27, 95% confidence interval [1.15, 1.41] and 1.45 [1.30, 1.61], respectively). Use of systemic antibiotics (3.16 [2.90, 3.44]), probiotics (2.53 [2.32, 2.77]), chemotherapy (1.28 [1.08, 1.53]), or proton pump inhibitors (PPIs) (1.17 [1.07, 1.28]), and prior CDI history (1.22 [1.03, 1.43]) were also identified as rCDI risk factors. Vancomycin reduced the risk of rCDI compared with metronidazole treatment (0.83 [0.76, 0.91]).

CONCLUSION:

This large, multicenter, nationwide study confirmed that older age, PPIs, antibiotics, probiotics, chemotherapy, and prior CDI history are risk factors for rCDI in Japan. There was a 17% decrease of rCDI risk with vancomycin vs metronidazole treatment.

CLINICAL TRIAL REGISTRATION NUMBER:N/A.

To review article in its entirety click on the link below to be redirected:

https://www.ncbi.nlm.nih.gov/pubmed/30987950?dopt=Abstract&utm_source=dlvr.it&utm_medium=twitter

Study Assessed Bezlotoxumab Cost Effectiveness Added To Standard of Care to Prevent rCDI In High-risk Patients From the Spanish National Health System

Abstract

Introduction

Clostridium difficile infection (CDI) is the major cause of infectious nosocomial diarrhoea and is associated with considerable morbidity, mortality and economic impact. Bezlotoxumab administered in combination with standard of care (SoC) antibiotic therapy prevents recurrent CDI.

This study assessed the cost-effectiveness of bezlotoxumab added to SoC, compared to SoC alone, to prevent the recurrence of CDI in high-risk patients from the Spanish National Health System perspective.

Methods

A Markov model was used to simulate the natural history of CDI over a lifetime horizon in five populations of patients at high risk of CDI recurrence according to MODIFY trials: (1) ≥ 65 years old; (2) severe CDI; (3) immunocompromised; (4) ≥ 1 CDI episode in the previous 6 months; and (5) ≥ 65 years old and with ≥ 1 CDI episode in the previous 6 months. The incremental cost-effectiveness ratio (ICER) expressed as cost per quality-adjusted life-year (QALY) gained was calculated. Deterministic (DSA) and probabilistic sensitivity analyses (PSA) were performed.

Results

In all patient populations (from 1 to 5), bezlotoxumab added to SoC reduced CDI recurrence compared to SoC alone by 26.4, 19.5, 21.2, 26.6 and 39.7%, respectively. The resulting ICERs for the respective subgroups were €12,724, €17,495, €9545, €7386, and €4378. The model parameters with highest impact on the ICER were recurrence rate (first), mortality, and utility values. The probability that bezlotoxumab was cost-effective at a willingness-to-pay threshold of €21,000/QALY was 85.5%, 54.1%, 86.0%, 94.5%, 99.6%, respectively.

Conclusion

The results suggest that bezlotoxumab added to SoC compared to SoC alone is a cost-effective treatment to prevent the recurrence of CDI in high-risk patients. The influence of changes in model parameters on DSA results was higher in patients ≥ 65 years old, with severe CDI and immunocompromised. Additionally, PSA estimated that the probability of cost-effectiveness exceeded 85% in most subgroups.

To review article in its entirety, please click on the following link:

https://link.springer.com/article/10.1007/s12325-018-0813-y

C Diff Foundation

Educating and Advocating for the Prevention, Treatments, Clinical Trials, Environmental Safety of Clostridioides difficile (C. diff. CDI C. difficile) Infections Worldwide

Tag Archives: rCDI Recurrenct C.diff. Infection

Microbiota Restoration in Recurrent C. difficile and COVID-19 : Sponsored by ACHL Academy for Continued Healthcare Learning Activity

Researchers Share Risk Factors for Recurrence of Clostridioides difficile (formally known as Clostridium difficile) Infection In Japan Real-World Analysis

Author information

Abstract

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

CLINICAL TRIAL REGISTRATION NUMBER:N/A.

To review article in its entirety click on the link below to be redirected:

Study Assessed Bezlotoxumab Cost Effectiveness Added To Standard of Care to Prevent rCDI In High-risk Patients From the Spanish National Health System

Abstract

Introduction

Clostridium difficile infection (CDI) is the major cause of infectious nosocomial diarrhoea and is associated with considerable morbidity, mortality and economic impact. Bezlotoxumab administered in combination with standard of care (SoC) antibiotic therapy prevents recurrent CDI.

This study assessed the cost-effectiveness of bezlotoxumab added to SoC, compared to SoC alone, to prevent the recurrence of CDI in high-risk patients from the Spanish National Health System perspective.

Methods

Results

Conclusion

Author information

Abstract

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

CLINICAL TRIAL REGISTRATION NUMBER:N/A.

To review article in its entirety click on the link below to be redirected:

<img loading="lazy" class="alignleft wp-image-166184" src="https://cdifffoundation.org/wp-content/uploads/2017/08/newsglobe.jpg?w=300" alt="" width="164" height="164">

Abstract

Introduction

Clostridium difficile infection (CDI) is the major cause of infectious nosocomial diarrhoea and is associated with considerable morbidity, mortality and economic impact. Bezlotoxumab administered in combination with standard of care (SoC) antibiotic therapy prevents recurrent CDI.

This study assessed the cost-effectiveness of bezlotoxumab added to SoC, compared to SoC alone, to prevent the recurrence of CDI in high-risk patients from the Spanish National Health System perspective.

Methods

Results

Conclusion