ADVERTISEMENT
Christina Ha, MD, on Treating Clostridioides difficile
Dr Ha reviews the essential steps to properly diagnosing and treating Clostridiodes difficile among patients with inflammatory bowel disease, which she presented at the AIBD regional meeting.
Christina Ha, MD, is a gastroenterologist specializing in the care of patients with inflammatory bowel disease at the Mayo Clinic in Scottsdale, Arizona.
--
TRANSCRIPT:
Christina Ha:
Hi, my name is Christina Ha. I'm from the Mayo Clinic in Arizona and I spoke about C. difficile and its role in inflammatory bowel disease. Remember, C. difficile is quite prevalent amongst our IBD patients, and endoscopically, it doesn't have the classic features of pseudomembranes. So when your IBD patients present with symptoms of a flare, C. difficile is something that's very important to rule out, even if they've had prior negative testing in the past.
But remember, C. difficile infection is identified by a two-step testing. A sizable percentage of our patients are colonizers of C. difficile. So a positive C. difficile PCR does not mean that there's active infection. It has to be the combination of the PCR plus something else, like the EIA test. Once you've identified them as positive, give them about 72 hours to turn around with the most appropriate treatment. In the outpatient setting, that's vancomycin, 125 milligrams four times daily.
We don't test a cure. And if they don't turn around in 72 hours, optimize their IBD treatment, because C. difficile can trigger worsened IBD outcomes, including hospitalizations, mortality, and colectomy, particularly among patients who are older who are on a lot of immunosuppression and high dose of steroids. So it's important to recognize, treat, and then optimize the UC early.
Also keep in mind we have multiple options to treat C. difficile now beyond just antibiotics, and fecal microbial transplantation is a safe option for our IBD patients in the appropriate setting. It may ultimately be a cost-effective strategy for recurrent infection amongst our patients. So recognize early, treat appropriately, and then optimize. Thank you so much.
--
