Do Oral Mechanical Bowel Solutions Cause C. Difficile Infection?

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DO ORAL MECHANICAL BOWEL SOLUTIONS CAUSE C. DIFFICILE INFECTION? INTRODUCTION: Bowel preparation traditionally consists of cathartics, oral antibiotics, and intravenous antibiotics. Previous studies have shown a strong relationship between the use of antibiotic bowel preparations and a higher rate of postoperative Clostridium difficile colitis due to disruption of the normal enteral microflora. Little data exists to show the relationship between the use of oral mechanical bowel solutions and the development of Clostridium difficile colitis. The aim of this study is to see whether oral mechanical bowel solutions, by themselves, can be implicated as causative agents in the development of Clostridium difficile colitis. HYPOTHESIS: We…show more content…
RESULTS: All n=24,522 patients received either GoLYTELY (Braintree Laboratories Inc, Braintree, Mass), HalfLytely & Bisacodyl Tablet Bowel Prep kit (Braintree Laboratories Inc, Braintree, Mass), Citrate of Magnesia (Aaron Industries Inc, Clinton, SC), or Fleet Phospho-soda (C. B. Fleet Co Inc, Lynchburg, Va) as oral bowel preparation solutions prior to their procedure. Group-A (Surgery group) consisted of 894 patients. Out of those only 45 (0.05%) had documented C. difficile infections. Furthermore, this subset of patients was broken down further to 7 (0.16%) having C. difficile infection upon their admission, 5 (0.11) who underwent emergent surgery and were excluded from the study. 18 (0.4%) other patients also underwent a subtotal colectomy for fulminant colitis and were also exluded. Of the remaining 3 patients, 2 (0.04%) had small bowel obstruction and 1 (0.02%) was treated with antibiotics days to weeks prior to admission, and so these patients were also excluded. This left us with 12 (27%) patients who actually qualified for our study. This group was broken down to 9 (0.2%) patients who were diagnosed with C difficile infection past the 30-day grace period, and 3 (0.07%) patients that were diagnosed within the 30-day grace period. This data suggests that out of the 861 patients examined, only 12 (0.01%) were diagnosed with C. difficile infection
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