VIDEO: Physicians should not ‘undertreat’ IBD patients with C. difficile infection
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In this Healio Gastroenterology video exclusive, Jessica R. Allegretti, MD, MPH, director of the fecal microbiota center at Brigham and Women’s Hospital, discussed treatment options for recurrence for Clostridioides difficile infection.
Allegretti moderated the symposium at Advances in Inflammatory Bowel Diseases 2021.
She said physicians need to be aware of the testing they are using when looking for C. difficile in patients with IBD.
“We also discussed the importance of not undertreating the patient’s inflammatory bowel disease,” she said. “The C. diff is likely to rev up the inflammatory bowel disease and you want to not shy away from using immunosuppression to treat it.”
She said once the patient has been diagnosed as having C. diff infection, they should be treated adequately for 48 to 72 hours. Then, physicians should assess for improvement and, if there is an improvement, they should continue with treatment. If there are no improvements, physicians need to escalate treatment for IBD because what they are seeing may be symptoms of an ongoing IBD flare.
According to Allegretti, regardless of severity, patients with IBD with first episode of C. diff should be treated with either vancomycin or Dificid (fidaxomicin, Merck).
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Allegretti JR, et al. Symposium: C. difficile Infection and Recurrence: Updated Treatment Strategies for Patients with Inflammatory Bowel Disease. Presented at: Advances in Inflammatory Bowel Diseases; Dec. 9-11, 2021 (virtual meeting).
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