Scientific Poster Session II - MeRIT Primer Participants (Proposed Research)

2023 MeRIT Primer Participants – Proposed Research
  Sunday, November 12, 2023
  12:45 PM–02:15 PM

Abstract

Introduction:

Clostridioides difficle infection (CDI) is the most common cause of nosocomial diarrhea and represents a major mortality and financial burden to the healthcare system. In vitro data suggest that tigecycline exerts inhibitory effects against Clostridioides difficle. Clinical evidence assessing the utility of tigecycline in the treatment of CDI is scarce and limited to case reports and small retrospective case series, precluding clinical action secondary to their results. Further observations could help define tigecycline’s utility in the treatment of CDI.

Research Question or Hypothesis:

To examine whether the provision of adjunctive tigecycline in the treatment of CDI results in an appreciable clinical benefit compared to a similarly matched patient cohort receiving guideline-directed standard antibiotic care.

Study Design: Retrospective, active comparator cohort study using a US healthcare claims database (i.e., TriNetX).

Methods:

The primary objective of this study is to determine if the addition of adjunctive tigecycline to usual antibiotic care improves 30-day mortality relative to guideline-directed standard antibiotic care alone. Secondary objectives included determining whether the provision of tigecycline affects rates of CDI recurrence or colectomy. Adult patients with an ICD-10-CM code indicating CDI and treatment with antibiotics directed against CDI within 24 hours of an eligible hospitalization will be included. Exposure status will be defined by tigecycline vs. “standard of care”, dependent on whether the patient received tigecycline within two days of the hospitalization. Outcomes will include 30-day mortality, CDI recurrence, and colectomy. We will identify confounders (e.g., clinical acuity, chronic comorbidities) according to the disjunctive cause criterion principle and adjust for them via propensity score matching. We will generate Kaplan Meier curves and estimate hazard ratios and 95% confidence intervals via Cox proportional hazards analysis.

Results:

To be collected.

Conclusion:

To be determined.

Presenting Author

Herman Johannesmeyer PharmD, BCPS
Marshall B. Ketchum University

Authors

Charles E. Leonard PharmD, MSCE
University of Pennsylvania Perelman School of Medicine

Aya Ozaki PharmD
University of California, Irvine School of Pharmacy and Pharmaceutical Sciences