{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T08:58:33Z","timestamp":1767085113279,"version":"3.30.1"},"reference-count":23,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T00:00:00Z","timestamp":1729209600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The incidence of <jats:italic>Clostridioides difficile<\/jats:italic> infection (CDI) in inflammatory bowel disease (IBD) is rising and associated with adverse outcomes. Optimal treatment for CDI in IBD remains unknown, with various organisations suggesting vancomycin as first\u2010line therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To compare treatment outcomes for metronidazole versus vancomycin in mild to moderate CDI in IBD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis of IBD patients with CDI between January 2015 and December 2019 was conducted. Laboratory data and clinical outcomes were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010seven discrete episodes of CDI in 34 patients occurred during the study period. Fifty\u2010three per cent (18) had Crohn's disease, 44% (15) ulcerative colitis and 3% (1) IBD unclassified. Six per cent (3\/47) of CDI cases were severe and excluded. In 68% (30\/44) of mild to moderate CDI, metronidazole was prescribed, with treatment failure in 20% (6\/30), CDI recurrence in 13% (4\/30) and 20% (6\/30) experiencing a further CDI episode. Comparatively, vancomycin was prescribed in 23% (10\/44) without any treatment failures; however, 10% (1\/10) had CDI recurrence and 40% (4\/10) experienced another CDI episode. No statistically significant difference was noted between metronidazole and vancomycin therapy for treatment failure (<jats:italic>P<\/jats:italic> =\u20090.31), CDI recurrence (<jats:italic>P<\/jats:italic> =\u20091.0) or further CDI episodes (<jats:italic>P<\/jats:italic> =\u20090.23). Proton\u2010pump inhibitor therapy was the only risk factor associated with a higher rate of the composite outcome and remained significant on multivariate logistic regression (odds ratio 12.99 (95% confidence interval\u2009=\u20091.21\u2013139.97), <jats:italic>P<\/jats:italic> = 0.03)<jats:italic>.<\/jats:italic><\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Metronidazole compared to vancomycin for treatment of mild to moderate CDI in IBD is effective however may be associated with higher rates of treatment failure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.16545","type":"journal-article","created":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T11:39:49Z","timestamp":1729251589000},"page":"2009-2014","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Treatment outcomes of mild to moderate <i>Clostridioides difficile<\/i> infection in inflammatory bowel disease: an <scp>Australian<\/scp> experience"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7195-3154","authenticated-orcid":false,"given":"Rachael","family":"Jacob","sequence":"first","affiliation":[{"name":"Department of Gastroenterology &amp; 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Hepatology Liverpool Hospital  Sydney New South Wales Australia"},{"name":"South Western Sydney Clinical School, University of New South Wales  Sydney New South Wales Australia"},{"name":"The Ingham Institute for Applied Medical Research  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1403772"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199401273300406"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1012413"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.5217\/ir.2020.00045"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mcg.0000139057.05297.d6"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2006.12.028"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2006.12.027"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01780.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2007.128231"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2016.10.024"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-009-0749-9"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjy143"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/1751-2980.12798"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.13027"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02606-13"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2008.09.003"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2009.05.031"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01275.x"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.108"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1086\/519265"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu313"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix1085"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01552-20"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.16545","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T05:11:05Z","timestamp":1733807465000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.16545"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,18]]},"references-count":23,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1111\/imj.16545"],"URL":"https:\/\/doi.org\/10.1111\/imj.16545","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"type":"print","value":"1444-0903"},{"type":"electronic","value":"1445-5994"}],"subject":[],"published":{"date-parts":[[2024,10,18]]},"assertion":[{"value":"2024-04-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}