Clinical outcomes of intravenous immune globulin in severe Clostridium difficile-associated diarrhea

被引:98
作者
Juang, Paul
Skledar, Susan J.
Zgheib, Nathalie K.
Paterson, David L.
Vergis, Emanuel N.
Shannon, William D.
Ansani, Nicole T.
Branch, Robert A.
机构
[1] Univ Pittsburgh, Med Ctr, Dept Pharm & Therapeut, Sch Pharm, Pittsburgh, PA 15213 USA
[2] Univ Pittsburgh, Med Ctr, Dept Infect Dis, Ctr Clin Pharmacol, Pittsburgh, PA 15213 USA
[3] Washington Univ, Sch Med, Div Gen Med, St Louis, MO USA
[4] Washington Univ, Sch Med, Div Biostat, St Louis, MO 63110 USA
关键词
D O I
10.1016/j.ajic.2006.06.007
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objectives: Our objective was to determine if use of intravenous immune globulin (IVIG) decreases the incidence of mortality, colectomies, and length of stay in the hospital in patients presenting with severe Clostridium dfficile-associated diarrhea (CDAD). Methods: A retrospective analysis was undertaken of 79 patients who had a positive C. difficile toxin titer and severe disease admitted to the University of Pittsburgh Medical Center Presbyterian between July 2001 and July 2003. Standard therapy for severe CDAD including intravenous metronidazole, oral vancomycin, or vancomycin enema was administered to all patients. Eighteen patients also received IVIG treatment (200-300 mg/kg) these were pair matched by propensity scoring with 18 patients who had the most similar characteristics and severity of CDAD from the available pool of 61 subjects who did not receive IVIG treatment. Results: No significant difference was observed in the baseline characteristics between the two groups. There were no statistical differences in clinical outcomes as measured by all cause mortality, colectomies, and length of stay. Conclusions: These data demonstrate that the use of IVIG in severe CDAD remains unsubstantiated. This study although limited by a small sample size, does not Support the use of IVIG at this dose for severe CDAD outside of a controlled trial.
引用
收藏
页码:131 / 137
页数:7
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