Reducing Infectious Diarrhea in Organ Transplant and Leukemia Patients

Infectious diarrhea caused by Clostridium difficile, can be reduced by giving vancomycin prophylactically especially in leukemia and blood bone marrow transplant patients.

The most common form of infectious diarrhea in hospitalized patients is caused by bacteria Clostridium difficile. Clostridium difficile infection (CDI) results in inflammation of the colon.

The most vulnerable population to develop CDI are those patients undergoing blood and bone marrow transplant (BMT) due to their prolonged hospitalization and previous exposure to antimicrobials.

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‘Infectious diarrhea caused by Clostridium difficile, can be reduced by giving vancomycin prophylactically especially in leukemia and blood bone marrow transplant patients.’
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The members of the Hematologic Malignancies Program at Rutgers Cancer Institute of New Jersey examined the use of a low dose of oral vancomycin. At higher dose, vancomycin is used to treat CDI and it is the first and only intervention that decreased CDI rates in a five-year period.

The results were presented at the American Society of Hematology Annual Meeting. The senior author of the study is Dennis Cooper, MD chief of Blood and Marrow Transplantation at Rutgers Cancer Institute and professor of medicine at Rutgers Robert Wood Johnson Medical School.

Infectious diarrhea caused by clostridium difficile has important implications for patients like morbidity and mortality, cost of therapy, and length of stay.

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BMT patients are at a greater risk of Clostridium difficile infections as they have a weak immune system. They also take have to medications that place them at a greater risk for infection.

To reduce the risk of CDI in these patients, a simple and less expensive approach of administering oral vancomycin prophylactically was initiated in December 2019. No side effects were seen after the drug administration.

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83 percent decrease of CDI was observed in the blood bone marrow transplant and leukemia population within the first eleven months of therapy. This is the first and only intervention that has helped to decrease the CDI rates in cancer in five years, however more time is needed to evaluate the effects of this approach.

At present, all transplant patients are given prophylactic oral vancomycin. Based on these findings, the prevention strategy with vancomycin can also be given to leukemia and solid organ transplant patients in other hospitals and institutes.

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Source-Medindia