English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Background Clostridioides difficile is the most common pathogen causing healthcare-associated infections in the United States and a Centers for Disease Control and Prevention urgent threat-level pathogen. The pathophysiology of C. difficile infection (CDI) involves neutrophil invasion of the colon associated with an inflammatory response. Previous case–control studies investigating an anti-inflammatory corticosteroid (CS) effect on CDI risk demonstrated conflicting results but were unable to control for antibiotic use. We hypothesized that CS use would decrease the risk of CDI in a well-matched, high-risk population. Methods This nested case–control study included hospitalized patients admitted to a single quaternary care hospital in the Texas Medical Center. The case population included adults who were diagnosed with CDI and received at least one dose of an antibiotic of interest (piperacillin–tazobactam, cefepime, or meropenem) in the 90 days prior to CDI diagnosis. The control population included hospitalized adults who received one of the same antibiotics during their hospital stay but did not develop CDI in the 90 days following their first dose. Patients were excluded if they had a documented history of CDI. CS use was defined as ≥ 20 mg prednisone or equivalent administered in the 48 hours prior to CDI diagnosis (cases) or antibiotic start (controls). The primary study outcome was the development of CDI. A logistic regression model was developed modeling CDI diagnosis as a function of available patient covariates. Results A total of 321 patients met the inclusion criteria; 56 patients had a history of CDI, leaving a final study cohort of 265 patients (104 cases and 161 controls). Antibiotic days of therapy were significantly higher in the control group (8 vs. 6 days; P = 0.02). The odds of CDI diagnosis were lower among patients administered CS (OR, 0.17; 95% CI, 0.08–0.38; P < 0.001), which remained protective in the multivariable model after adjusting for age, gender, and invasive GI surgery within 6 months. Conclusion We observed an association between CS use and decreased risk of developing primary CDI in hospitalized patients receiving broad-spectrum antibiotics. Future studies are needed to delineate the dose and duration of CS needed to realize this effect. Disclosures All authors: No reported disclosures.

open forum infectious diseases

2378. Corticosteroid Use Prevents Primary Clostridioides difficile Infection in the Setting of Broad-Spectrum Antibiotic Use Among Hospitalized Patients