Evaluation of aztreonam versus other anti-gram-negative antibiotics in risk for Clostridium difficile recurrence Rima Patel, Pharm.D.; Linda Johnson, Pharm.D., BCPS; Cuilan Gao, Ph.D. Memorial Health Care System - Chattanooga, TN
Background/Purpose: Widespread antimicrobial drug use has been associated with Clostridium difficile infections (CDI). The presumed mechanism by which antimicrobials induce CDI is through disruption of the indigenous microflora of the colon, thereby allowing C. difficile to grow to high concentrations. Antibiotics, such as aztreonam, which cause minimal disruption of the anaerobic microflora are thought to prevent colonization of C. difficile. Based on this hypothesis, providers at CHI Memorial often prescribe aztreonam in patients with a history of CDI to prevent recurrence. However, there is a lack of clinical evidence to support the use of this medication in this patient population. This study aimed to evaluate the effect of aztreonam versus other anti-gram-negative agents in CDI rates in patients with a history of CDI.
Methodology: A single-center retrospective cohort analysis was conducted from July 2015-July 2017. Adult inpatients with CDI who received antibiotics >/= 48 hours post the diagnosis and within 3 months post the completion of CDI treatment were included. Patients who expired within 3 months of CDI diagnosis and patients who received only one dose of any gram negative antibiotic were excluded. Primary endpoint was the difference in CDI recurrence in each group within 3 months of receiving antibiotics. Secondary endpoints included the rate of recurrent CDI in a subgroup of patients, who completed treatment for CDI prior to receiving an antibiotic, and clinical deterioration (non-CDI related) within 7 days of starting antibiotics._x000D_
Results: N/A
Conclusions: N/A
Presentation Objective: Identify if the use of aztreonam in patients with history of C. difficile could lead to less recurrent CDI vs. other anti-gram negative agents.
Self-Assessment: What are the potential risk factors for C. difficile infection recurrence?
