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30-day Mortality Down With Vancomycin in C. difficile

30-day Mortality Down With Vancomycin in C. difficile
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TUESDAY, Feb. 7, 2017 (HealthDay News) — For patients with Clostridium difficile infection (CDI), recurrence rates are similar with vancomycin and metronidazole treatment, but the risk of 30-day mortality is significantly reduced with vancomycin, according to a study published online Feb. 6 in JAMA Internal Medicine.

Vanessa W. Stevens, Ph.D., from the Veterans Affairs Salt Lake City Health Care System in Utah, and colleagues conducted a retrospective propensity-matched cohort study involving patients treated for CDI. The authors assessed the risk of recurrence and all-cause 30-day mortality among 47,147 patients receiving metronidazole or vancomycin. Of these patients 2,068 were treated with vancomycin and matched to 8,069 patients treated with metronidazole.

The researchers found that the risk of recurrence did not differ for patients treated with vancomycin versus metronidazole in any of the disease severity cohorts. For patients in the any severity cohort, the risk of dying was reduced with vancomycin treatment (adjusted relative risk, 0.86). Mortality risk did not differ significantly between the treatment groups for those with mild-to-moderate CDI; among patients with severe CDI, vancomycin was associated with significantly reduced all-cause mortality (adjusted relative risk, 0.79).

“Our findings may further justify the use of vancomycin as initial therapy for severe CDI,” the authors write.

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