A preliminary study of bowel rest strategy in the management of Clostridioides difficile infection

• Published in: Scientific reports Vol. 10; no. 1; p. 22061
• Main Authors: Sugimoto, Hiroshi, Yoshihara, Ayaka, Yamamoto, Takao, Sugimoto, Keisuke
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 16.12.2020; Nature Publishing Group; Nature Portfolio
• Subjects: 692/308/409; 692/4020/1503/1581/1422; 692/699/255/1911; Aged; Aged, 80 and over; Clostridioides difficile; Clostridium Infections - drug therapy; Clostridium Infections - mortality; Cross Infection; Diarrhea; Diarrhea - drug therapy; Diarrhea - microbiology; Diarrhea - mortality; Disease-Free Survival; Female; Hospitals; Humanities and Social Sciences; Humans; Intestine; Male; Metronidazole; Metronidazole - administration & dosage; Mortality; multidisciplinary; Nosocomial infection; Nosocomial infections; Retrospective Studies; Science; Science (multidisciplinary); Statistical analysis; Survival Rate; Vancomycin; Vancomycin - administration & dosage
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-020-79211-3

Clostridioides difficile infection (CDI) is an important nosocomial infection and is the leading cause of infectious diarrhea in hospitalized patients. We aimed to assess the effect of bowel rest on the management of CDI. A single-center retrospective cohort study was conducted. The primary outcome was the composite of the all-cause mortality and CDI recurrence within 30 days. The main secondary outcome was switching from metronidazole to vancomycin. Of the 91 patients with CDI enrolled as the full cohort, 63 patients (69%) and 28 patients (31%) constituted the control group and the bowel rest group, respectively. After one-to-one propensity score matching, a total of 46 patients were included as the matched cohort. In the full cohort, the composite outcome occurred in 19.0% and 14.3% of the patients in the control and the bowel rest group, respectively (p = 0.768). In the matched cohort, it was 17.4% in each group. Although there was no statistically significant difference, the trend of switching was lower in the bowel rest group. The bowel rest may not affect the all-cause mortality and CDI recurrence within 30 days. However, in those prescribed bowel rest, switching from metronidazole to vancomycin may reduce.