Prediction Rule of Reveles et al for Recurrent Clostridium difficile Colitis

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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Prediction Rule of Reveles et al for Recurrent Clostridium difficile Colitis

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