Implementation of routine Clostridioides difficile infection (CDI) primary prophylaxis in lung transplant recipients

Clin Transplant. 2023 Sep;37(9):e15079. doi: 10.1111/ctr.15079. Epub 2023 Jul 21.

Abstract

Lung transplant recipients are at an increased risk for Clostridioides difficile infection (CDI), and those who develop CDI post-transplant can have worsened outcomes including graft failure and death. We sought to describe the efficacy and safety of primary CDI prophylaxis with oral vancomycin among 86 adult lung transplant recipients. Overall, we observed a 9.3% (8/86) incidence of CDI among patients receiving prophylaxis, with the majority of infections occurring a median of 25 days after completion of prophylaxis. Furthermore, we observed a 4.7% incidence of VRE infection/colonization. Opportunities exist to optimize the duration of CDI prophylaxis to balance the benefits and risks in lung transplant recipients.

Keywords: antibiotic prophylaxis; bacterial: Clostridium difficile; infection and infectious agents; lung (allograft) function/dysfunction.

MeSH terms

  • Administration, Oral
  • Aged
  • Anti-Bacterial Agents* / administration & dosage
  • Clostridioides difficile*
  • Clostridium Infections* / epidemiology
  • Clostridium Infections* / prevention & control
  • Female
  • Humans
  • Incidence
  • Lung Transplantation* / adverse effects
  • Male
  • Middle Aged
  • Primary Prevention* / methods
  • Retrospective Studies
  • Vancomycin* / administration & dosage

Substances

  • Vancomycin
  • Anti-Bacterial Agents