Hospital-onset Clostridioides difficile infection in high risk patients of Thammasat hospital Clostridium Infections
Conditions
Interventions
Patients in this group will receive vancomycin 125 mg orally once daily while hospitalized, starting from the day they begin systemic antibiotics and continuing for 5 days after discontinuation of ant
Experimental Drug,No Intervention No treatment
Vancomycin prophylaxis,Non vancomycin prophylaxis
Sponsors
Faculty of Medicine, Thammasat University
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Patients in the internal medicine department at Thammasat University Hospital who have been hospitalized for at least 4 days and have received systemic antibiotics, along with at least one of the following risk factors 1. Age 65 years and older 2. Recent hospitalization or stay in a care facility within the past 3 months 3. Immunocompromised conditions, such as AIDS with CD4 less than 200 or cancer undergoing chemotherapy 4. Use of immunosuppressive drugs, including Prednisolone at least 20 mg/day (for at least 14 days), TNF inhibitors, Rituximab, Anakinra (IL-1 antagonist), Toclizumab (IL-6 antagonist), Alemtuzumab, Cyclophosphamide, or 5FU 5. History of abdominal surgery 6. Diabetes or end-stage kidney disease 7. Previous Clostridioides difficile infection (CDI) 8. Organ transplant or stem cell transplant recipients
Exclusion criteria
Exclusion criteria: 1. Unable to provide informed consent. 2. Currently experiencing Clostridioides difficile infection. 3. Receiving Metronidazole or oral vancomycin treatment for other indications. 4. Unable to take oral vancomycin. 5. Currently taking probiotics. 6. History of vancomycin allergy or contraindications to its use. 7. Pregnant. 8. Previously treated for Clostridioides difficile infection using alternative methods such as fecal transplantation or received CDI treatment within the past month. 9. Expected to be discharged within 48 hours after enrollment in the study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of hospital-onset Clostridioides difficile infection At 30 days after study enrollment Diagnosis based on at least 3 loose stools per day for at least 24 hours from hospital day 4, plus a positive GDH and toxin A/B or GDH positive with clinical diagnosis and treatment by a physician | — |
Secondary
| Measure | Time frame |
|---|---|
| VRE and CRE infection At 30 days after study enrollment VRE and CRE infections will be identified from positive clinical cultures (blood, urine, wound, respiratory) and defined by clinician judgment ( bloodstream infection, UTI, pneumonia, wound infection),overall in hospital mortality At 30 days after study enrollment Identify deaths from electronic medical records (EMR) or discharge summaries,Length of hospital stay Within admission Calculate total days hospitalized from admission and discharge date | — |
Countries
Thailand
Contacts
Public ContactWorapong Treewarunyu
Thammasat University
Outcome results
None listed