Efficacy of prolonged tapered and pulsed vancomycin regimen on recurrent Clostridioides difficile infection in the Japanese setting: a case control study
Abstract Background According to the Clinical Practice Guidelines for Clostridioides difficile, oral vancomycin is to be used in vancomycin tapered and pulsed regimen (VCM-TP) for recurrent Clostridium difficile infection (CDI). However, data on the efficacy of VCM-TP in Japanese patients with recur...
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doaj-809b08091fde4237b29361eaedd9809b2020-11-25T02:58:24ZengBMCJournal of Pharmaceutical Health Care and Sciences2055-02942019-08-01511610.1186/s40780-019-0147-1Efficacy of prolonged tapered and pulsed vancomycin regimen on recurrent Clostridioides difficile infection in the Japanese setting: a case control studyTakumi Umemura0Aiko Ota1Yoshikazu Mutoh2Chihiro Norizuki3Takahito Mizuno4Koji Kozaki5Yoshiaki Ikeda6Toshihiko Ichihara7Department of Pharmacy, Tosei General HospitalDepartment of Pharmacy, Tosei General HospitalDepartment of Infection and Prevention, Tosei General HospitalDepartment of Infection and Prevention, Tosei General HospitalDepartment of Pharmacy, Tosei General HospitalDepartment of Pharmacy, Tosei General HospitalCollege of Pharmacy, Kinjo Gakuin UniversityDepartment of Infection and Prevention, Tosei General HospitalAbstract Background According to the Clinical Practice Guidelines for Clostridioides difficile, oral vancomycin is to be used in vancomycin tapered and pulsed regimen (VCM-TP) for recurrent Clostridium difficile infection (CDI). However, data on the efficacy of VCM-TP in Japanese patients with recurrent CDI are scarce. To address this gap, we investigated the efficacy of VCM-TP and performed a case-controlled study to assess the risk factors associated with treatment failure in these patients. Findings We conducted this study on all patients who were administered VCM-TP for recurrent episodes of CDI between January 2008 and December 2018 at Tosei General Hospital. All patients had documented follow-ups within 90 days after completion of the VCM-TP. Data were obtained for comparative analysis of treatment success or failure. Thirty-six patients were eligible for this study, and treatment success was documented in 23 patients (63.9%) following VCM-TP treatment. Treatment success was documented in 22 of 30 (73.3%) patients who received the recommended therapy according to the Clinical Practice Guidelines. The frequency of patients treated with the recommended therapy was higher in the treatment success group (95.7%) than in the treatment failure group (61.5%) (OR: 13.75, 95% CI: 1.39–136.39, p = 0.016). Vancomycin-resistant enterococci culture tests were performed in 20 patients (55.6%), and all results were negative. Conclusions Our findings suggest that VCM-TP is a good therapeutic option for recurrent CDI in Japanese patients. Furthermore, administration of the recommended VCM-TP is important for achieving a high rate of treatment success. Hence, antimicrobial stewardship teams should support the implementation of recommended VCM-TPs.http://link.springer.com/article/10.1186/s40780-019-0147-1VancomycinVancomycin tapered and pulsed dose regimenClostridioides difficile infection |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Takumi Umemura Aiko Ota Yoshikazu Mutoh Chihiro Norizuki Takahito Mizuno Koji Kozaki Yoshiaki Ikeda Toshihiko Ichihara |
spellingShingle |
Takumi Umemura Aiko Ota Yoshikazu Mutoh Chihiro Norizuki Takahito Mizuno Koji Kozaki Yoshiaki Ikeda Toshihiko Ichihara Efficacy of prolonged tapered and pulsed vancomycin regimen on recurrent Clostridioides difficile infection in the Japanese setting: a case control study Journal of Pharmaceutical Health Care and Sciences Vancomycin Vancomycin tapered and pulsed dose regimen Clostridioides difficile infection |
author_facet |
Takumi Umemura Aiko Ota Yoshikazu Mutoh Chihiro Norizuki Takahito Mizuno Koji Kozaki Yoshiaki Ikeda Toshihiko Ichihara |
author_sort |
Takumi Umemura |
title |
Efficacy of prolonged tapered and pulsed vancomycin regimen on recurrent Clostridioides difficile infection in the Japanese setting: a case control study |
title_short |
Efficacy of prolonged tapered and pulsed vancomycin regimen on recurrent Clostridioides difficile infection in the Japanese setting: a case control study |
title_full |
Efficacy of prolonged tapered and pulsed vancomycin regimen on recurrent Clostridioides difficile infection in the Japanese setting: a case control study |
title_fullStr |
Efficacy of prolonged tapered and pulsed vancomycin regimen on recurrent Clostridioides difficile infection in the Japanese setting: a case control study |
title_full_unstemmed |
Efficacy of prolonged tapered and pulsed vancomycin regimen on recurrent Clostridioides difficile infection in the Japanese setting: a case control study |
title_sort |
efficacy of prolonged tapered and pulsed vancomycin regimen on recurrent clostridioides difficile infection in the japanese setting: a case control study |
publisher |
BMC |
series |
Journal of Pharmaceutical Health Care and Sciences |
issn |
2055-0294 |
publishDate |
2019-08-01 |
description |
Abstract Background According to the Clinical Practice Guidelines for Clostridioides difficile, oral vancomycin is to be used in vancomycin tapered and pulsed regimen (VCM-TP) for recurrent Clostridium difficile infection (CDI). However, data on the efficacy of VCM-TP in Japanese patients with recurrent CDI are scarce. To address this gap, we investigated the efficacy of VCM-TP and performed a case-controlled study to assess the risk factors associated with treatment failure in these patients. Findings We conducted this study on all patients who were administered VCM-TP for recurrent episodes of CDI between January 2008 and December 2018 at Tosei General Hospital. All patients had documented follow-ups within 90 days after completion of the VCM-TP. Data were obtained for comparative analysis of treatment success or failure. Thirty-six patients were eligible for this study, and treatment success was documented in 23 patients (63.9%) following VCM-TP treatment. Treatment success was documented in 22 of 30 (73.3%) patients who received the recommended therapy according to the Clinical Practice Guidelines. The frequency of patients treated with the recommended therapy was higher in the treatment success group (95.7%) than in the treatment failure group (61.5%) (OR: 13.75, 95% CI: 1.39–136.39, p = 0.016). Vancomycin-resistant enterococci culture tests were performed in 20 patients (55.6%), and all results were negative. Conclusions Our findings suggest that VCM-TP is a good therapeutic option for recurrent CDI in Japanese patients. Furthermore, administration of the recommended VCM-TP is important for achieving a high rate of treatment success. Hence, antimicrobial stewardship teams should support the implementation of recommended VCM-TPs. |
topic |
Vancomycin Vancomycin tapered and pulsed dose regimen Clostridioides difficile infection |
url |
http://link.springer.com/article/10.1186/s40780-019-0147-1 |
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