P0951 - Both Fidaxomicin and Vancomycin are Effective in Treating Clostridiodes difficile Infection in Inflammatory Bowel Disease Patients

Thabet Qapaja, MD¹, Mohammed Abu-Rumaileh, MD², Rashid Abdel-Razeq, MD¹, Mohamad-Noor Abu-Hammour, MD³, Mounir Ibrahim, MD⁴, Faris Hammad, MD⁵, Miguel D Regueiro, MD^1
1Cleveland Clinic, Cleveland, OH; ²University of Toledo, Toledo, OH; ³Cleveland Clinic Fairview, Cleveland, OH; ⁴Cleveland Clinic Foundation, Holmdel, NJ; ⁵Cleveland Clinic Foundation, Westlake, OH

Introduction: Inflammatory Bowel Disease (IBD) patients who develop Clostridiodes difficile infection (C. difficile) face significant treatment challenges. While both fidaxomicin and vancomycin are established treatments for C. difficile infection, their comparative efficacy in IBD patients has not been well studied.

Methods: Using the TriNetX multi-institutional database, we identified IBD patients with an ICD-10 code for C. difficile or a positive nucleic acid amplification test (NAAT) for toxin who received either fidaxomicin or vancomycin. Patients were propensity score-matched for demographics, comorbidities, and IBD medications. Outcomes, including all-cause mortality, acute kidney injury (AKI), recurrent C. difficile infection, and colectomy, were assessed 3 months from the index infection.

Results: After propensity score matching, 3,443 patients were included in each treatment group. No statistically significant differences were found between the fidaxomicin and vancomycin groups in terms of all-cause mortality (6.48% vs 6.84%; aOR: 0.94; 95% CI: 0.78-1.14; p=0.55), recurrent C. difficile (12.03% vs. 11.55%; aOR: 1.048; 95% CI: 0.89-1.23; p=0.57), or colectomy (1.94% vs. 2.07%; aOR: 0.94; 95% CI: 0.66-1.32; p=0.70) for patients treated with fidaxomicin and vancomycin respectively. However, AKI was higher in the vancomycin group (17.25% vs 15.39%; aOR: 0.87; 95% CI: 0.77-0.99; p=0.037) compared to the fidaxomicin group.

Discussion: Both fidaxomicin and vancomycin are effective in treating C. difficile infection in IBD patients. Further prospective studies are warranted to confirm these findings and optimize treatment strategies for this patient population.


Disclosures:


Thabet Qapaja, MD¹, Mohammed Abu-Rumaileh, MD², Rashid Abdel-Razeq, MD¹, Mohamad-Noor Abu-Hammour, MD³, Mounir Ibrahim, MD⁴, Faris Hammad, MD⁵, Miguel D Regueiro, MD¹. P0951 - Both Fidaxomicin and Vancomycin are Effective in Treating <i>Clostridiodes difficile</i> Infection in Inflammatory Bowel Disease Patients, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.