2109. Vancomycin as Prophylaxis of Relapsing Clostridium difficile Infection
Session: Poster Abstract Session: Clostridium difficile: Therapeutics
Saturday, October 29, 2016
Room: Poster Hall
Background: Clostridium difficile-infection (CDI) is the most common cause of infectious nosocomial diarrhea in developed countries and is a high burden to the entire health care industry. CDI is caused by an overgrowth of C. difficile due to antibiotic use and relapse rates are estimated to be between 20-40%. There is conflicting evidence in existing literature regarding the efficacy of oral vancomycin prophylaxis in decreasing CDI recurrence rates. In this retrospective study -we have attempted to address this dilemma. We have identified patients with recent or recurrent CDI who received antibiotics after an episode of CDI and were given prophylaxis with oral vancomycin. The relapse rate of this group was then compared to the relapse rate of all patients with CDI in our institution.

Methods: Between 2010 and 2015 - we identified all adult inpatients (age >18) who have a history of recent CDI within 6 months of receiving other antibiotics and identified the subset who received oral vancomycin prophylaxis while on antibiotics. We determined the 6 month relapse rate of this group and compared this relapse rate to all patients at our institution who have a history of recent CDI.

Results: A total of 945 patients met our initial screening criteria but only 90 were determined to have both a history of recent or recurrent CDI and had received prophylaxis with oral vancomycin. Only 6 experienced a recurrent episode of CDI within 6 months accounting for a relapse rate of 6.67%. For our control group - we identified 7445 patients who were diagnosed with Clostridium difficile infection between 2010 and 2015. Out of this group - 1661 patients experienced an episode of recurrent CDI within 6 months. The 6 month relapse rate for our control group was calculated to be 22.2%.

Conclusion: Our findings indicate that oral vancomycin prophylaxis is effective in reducing the relapse rate in patients with a history of recent or recurrent CDI who require treatment with antibiotics as evidenced by the significantly reduced 6 month CDI relapse rate of 6.67% as compared to 22.2% in the control group.

Valida Bajrovic, M.D. and Matthew Sims, MD, PhD, FIDSA, Infectious Diseases, Beaumont Health System, Royal Oak, MI

Disclosures:

V. Bajrovic, None

M. Sims, None

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