Clostridium difficile infection (CDI) treatment in a hospital setting using low dose oral vancomycin showed similar effectiveness compared to high dose, according to a new study by researchers at Montefiore Medical Center and Albert Einstein College of Medicine of Yeshiva University. These data were presented yesterday at the 53rd Annual Interscience Conference on Antimicrobial Agents and Chemotherapy meeting in Denver.
Patients with CDI treated with vancomycin at the low dose (LD) (125 mg every 6 hours) and high dose (HD) (greater than 125mg every 6 hours) showed clinical improvements 72 hours after administration (85% and 86%, respectively).
CDI is an infection of the large bowel that can result in mild to severe symptoms including stomach pain, severe cramping, profuse diarrhea, and, in the most severe form, can lead to death. CDI is linked to 14,000 deaths each year in the United States, according to the Centers for Disease Control and Prevention.
"This study's comparable results in low dose and high dose antibiotic treatment of CDI reinforce the importance of considering new approaches to using these medications," said Philip Chung, PharmD, M.S., clinical pharmacy manager in Infectious Diseases, Montefiore Medical Center and assistant professor of medicine, Department of Medicine (Infectious Diseases), Einstein. "Antibiotic stewardship is an important focus in hospitals today. We are using our study findings to develop treatment guidelines that encourage low dose treatment."
Comparable results in the LD and HD groups were shown in secondary endpoints, including rates of clinical improvement at end of therapy or time of hospital discharge (93% and 95%, respectively), in-hospital mortality (15% and 23%), re-treatment (4% and 6%), and 30-day readmission (34% and 24%).