P174 - CLOSTRIDIUM DIFFICILE IN INFLAMMATORY BOWEL DISEASE: WHICH TREATMENT REGIMEN IS SUPERIOR?
(Room Poster Hall)
19 Jan 18
5:30 PM
-
7:00 PM
Tracks:
Management of Complicated IBD
Introduction: The incidence of Clostridium difficile infection (CDI) has been rising and its occurrence in Inflammatory Bowel Disease (IBD) is higher than the general population, yet there is no treatment protocol in these patients. Our study's goal was to determine if there is a superior treatment regimen for CDI in IBD patients. Methods: Patients with IBD and CDI in the inpatient or outpatient setting at Cooper Hospital from 2008 to 2016 were included in this retrospective cohort study. Data were obtained through chart review. Patients were categorized based on treatment regimens: vancomycin, metronidazole, or combination. Differences among therapies were compared using Wilcoxon rank sums test for continuous variables and Fisher’s exact test for categorical variables. Differences among therapies were compared using ANOVA on ranks for continuous and categorical variables. A p-value of 0.05 was used for statistical significance. Results: We found 43 occurrences of CDI in IBD patients, of which 8 were treated with combination therapy, 19 with metronidazole, and 16 with vancomycin. 1 occurrence failed treatment with combination therapy (12.5%), 3 with metronidazole (15.8%), and 2 with vancomycin (13.3%). The differences among these were not statistically significant (combination vs. metronidazole p=0.8265, combination vs. vancomycin p=0.9549, metronidazole vs. vancomycin p=0.8410). 3 occurrences in the combination group resulted in recurrence (37.5%), 4 in the metronidazole group (21%), and 7 in the vancomycin group (43.75%). The differences in these were not statistically significant (combination vs. metronidazole p=0.3791, combination vs. vancomycin p=0.7699, metronidazole vs. vancomycin p=0.1565). Conclusions: Although the combination group had a lower rate of treatment failure, no treatment regimen of CDI was found to be significantly superior in our IBD population. More studies with a larger sample size need to be done to find a statistical difference.