Doxycycline tied to lower risk for C. difficile in pneumonia patients (Azithromycin was worse)

Medical Xpress / HealthDay / American Journal of Infection Control ^ | Dec. 2, 2023 | Elana Gotkine / Ashley L. O'Leary et al

[ConservativeMind]

For patients with community-acquired pneumonia (CAP), doxycycline is associated with a reduced risk for Clostridioides difficile infection (CDI), according to a study.

Ashley L. O'Leary, Pharm.D., from the Veterans Affairs Western New York Healthcare System in Buffalo, and colleagues conducted a retrospective analysis in hospitalized patients in Veterans Affairs Hospitals across the United States to examine whether doxycycline is associated with reduced CDI risk.

During the study timeframe, about 156,107 hospitalized patients received care at a Veterans Affairs Hospital and were diagnosed with CAP. The researchers found that compared with azithromycin, doxycycline used with ceftriaxone for the treatment of pneumonia was associated with a 17 percent reduced risk for CDI. The incidence of CDI was reduced by 45 percent for patients who had a prior history of CDI (odds ratio, 0.55).

"Our analysis found that in patients with a prior history of C. diff, doxycycline was the only factor associated with a reduction in the incidence of new C. diff infections," senior author Kari A. Mergenhagen, Pharm.D. said in a statement. "These results suggest that in cases where Legionella pneumonia can be ruled out prior to treatment, patients at increased risk of C. diff may benefit from the use of doxycycline as a first-line agent."

[ConservativeMind]

From the write up:

“The researchers found that compared with azithromycin, doxycycline used with ceftriaxone for the treatment of pneumonia was associated with a 17 percent reduced risk for CDI. The incidence of CDI was reduced by 45 percent for patients who had a prior history of CDI (odds ratio, 0.55).”

[ConservativeMind]

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[silverleaf]

Vets still serving their country as medical guinea pigs

Wonder how many died when doxcy was withheld

[ConservativeMind]

In this case, they got a different decent antibiotic, but this one, which we’ve all probably had at some point in our lives, was found to wipe out too many other bacteria, leading to overgrowth of a really bad one.

[ducttape45]

I just took azithromycin for treatment of a chest/flu bug. Wow, that drug, coupled with my Long Covid, really did a number on me. I won’t ever take that again, and I’m gonna let me doctor know never to prescribe it again. I still haven’t completely recovered after taking it.

[sauropod]

.

[yefragetuwrabrumuy]

The Japanese have had and used a preventative to C. difficile for decades now. It is called C. butyricum MIYARI. That is, a different form of clostridium that competes with and overwhelms difficile in the GI tract.

It is so effective that it is routinely given to patients in hospitals to prevent outbreaks. If you buy some off of Amazon, it does take 2-3 weeks to deliver from the single manufacturer.

But it’s a godsend when there is an outbreak of C. difficile, which gives you about a month of miserable diarrhea and leaves you exhausted. So it’s great to have a bottle in your medicine chest.