Philadelphia—Prophylactic use of oral vancomycin shows promise for preventing Clostridium difficile infection in immune-suppressed cancer patients.
That’s according to a study presented recently at the 58th Annual American Society of Hematology Meeting and Exposition in San Diego.
Background information in the article notes that C difficile is one of the most common—and expensive to treat—infections contracted by hospitalized patients undergoing bone-marrow transplantation for the treatment of blood cancers. The average cost of a case ranges from $8,911 to $30,049 per patient, according to the research.
For the study, a team led by researchers Abramson Cancer Center at the University of Pennsylvania began giving oral vancomycin on a preventative basis to blood-cancer patients undergoing an allogeneic stem cell transplant. The antibiotic was administered twice daily from admission discharge to help protect the patients, whose immune systems are suppressed so they do not reject donor bone marrow cells.
Results indicate that, of the 73 patients who took the drug prophylactically, none developed C difficile during their inpatient admission for the stem cell transplant, which lasted an average of 33 days. On the other hand, in a group of patients who did not get the drug in advance, 20% developed the infection, which is within the national average of between 20% to 30%, researchers point out.
“This is the first study to evaluate this preventative strategy in stem cell transplant recipients, and the results are encouraging,” said the study’s lead author Alex Ganetsky, PharmD, a clinical pharmacist in the Blood and Marrow Transplantation Program in the Abramson Center. “This may become the standard of care at Penn among patients receiving allogeneic stem cell transplants.”
“What we want to do is maximize the appropriate use of antibiotics,” added senior author David Porter, MD, the director of Blood and Marrow Transplantation and Jodi Fisher Horowitz Professor in Leukemia Care Excellence in the Abramson Cancer Center. “With our control group showing a 20 percent infection rate, that means we’re giving the antibiotics to a lot of people who would not have otherwise developed C diff, but given the risks associated with the condition for these patients, our results demonstrate a potential path to protecting more of them during a very vulnerable period in their recovery.”
While the treatment has proven effective at preventing C difficile, the study did not show a shortened length of hospitalization among the patients.
“This was a retrospective analysis, so we need to follow up with randomized trials that specifically look at length of stay,” Porter said. “Finding such a drop-off in C diff is enough to push us to continue this line of study.”
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