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Description

Reveles et al reported a prediction rule for recurrent Clostridium difficile disease. This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Texas at Austin, UT Health San Antonio, South Texas Veterans Health Care Sytem, University of Texas Southwestern and VA North Texas Health Care System.


Patient selection: Veterans Administration patients

 

Outcome: recurrent Clostridium difficile disease within 60 days

 

Parameters:

(1) past history of therapy with a third or fourth generation cephalosporin

(2) past history of therapy with a proton pump inhibitor (PPI)

(3) prior therapy with antidiarrheal agents

(4) severity of the Clostridium difficile infection

(5) community-onset Clostridium difficile disease

 

Parameter

Finding

Points

past history of therapy with third or fourth generation cephalosporin

no

0

 

yes

1

past history of therapy with a proton pump inhibitor

no

0

 

yes

1

prior therapy with an antidiarrhea agent

no

0

 

yes

1

severity of Clostridium difficile disease

mild or moderate

2

 

severe

0

community-acquired infection

no

0

 

yes

3

 

total score =

= SUM(points for all 5 parameters)

 

Interpretation:

minimum score: 0

maximum score: 8

The higher the score the greater the risk of recurrent C. difficile disease.

 

Total Score

Risk Group

Rate of Recurrence

0 to 2

low

9%

3 to 5

medium

20%

6 to 8

high

35%

 


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