Continuous Infusion of Lidocaine in Pediatric Colonoscopy: A Randomized Placebo-Controlled Study

2020 ◽  
Author(s):  
Chao Yuan ◽  
Chengli Wang ◽  
Jiayao Wu ◽  
Ningyang Gao ◽  
Kuiwei Li ◽  
...  
Keyword(s):  
Continuous Infusion ◽  
Recovery Time ◽  
Oxygen Desaturation ◽  
Secondary Outcome ◽  
Controlled Study ◽  
Control Group ◽  
Intravenous Lidocaine ◽  
Lidocaine Group ◽  
Significant Difference ◽  
Pediatric Colonoscopy

Abstract Background: To investigate the effect of intravenous lidocaine on perioperative propofol and sufentanil dosage, pulse oxygen saturation, postoperative pain score and recovery time during pediatric colonoscopy.Methods: We designed a randomized placebo-controlled study and enrolled 80 children aged from 3 to 10 years old who were received colonoscopy. After titration of propofol to achieve unconsciousness, patients were given intravenous lidocaine (1.5 mg kg-1 then 2 mg kg-1 h-1) or the same volume of saline. Sedation was standardized and combined propofol with sufentanil. The primary outcome variables were intraoperative propofol and sufentanil requirements and number of oxygen desaturation episodes. Secondary outcome variables were recovery time after colonoscopy and post-colonoscopy pain.Results: Lidocaine infusion resulted in a significant reduction in propofol requirements: mean (SD) 44.3 (9.9) vs 74.5 (12.0) mg, respectively; P<0.001) and sufentanil requirements: mean (SD) 1.5 (0.3) vs 2.6 (0.6) ug respectively; p<0.001). The number of subjects who experienced oxygen desaturation below 95% in the lidocaine group was also significantly less than that in the control group: 2 vs 8 (P=0.04). The mean (SD) recovery time was significantly shorter in lidocaine group: 19.2 (2.6) vs 13.3 (2.6) min respectively; p<0.001). There were no significant difference regarding post-colonoscopy pain.Conclusions: Continuous infusion of lidocaine resulted in reduction of propofol and sufentanil dose, recovery time and risk of hypoxemia during pediatric colonoscopy.Trial Registration: Chinese Clinical Trials Registry, ChiCTR2000028927, 8 January, 2020, prospectively registered.

scholarly journals Continuous Infusion of Lidocaine in Pediatric Colonoscopy: A Randomized Double-Blind Placebo-Controlled Study

2021 ◽  
Author(s):  
Chao Yuan ◽  
Chengli Wang ◽  
Jiayao Wu ◽  
Ningyang Gao ◽  
Kuiwei Li ◽  
...  
Keyword(s):  
Continuous Infusion ◽  
Recovery Time ◽  
Oxygen Desaturation ◽  
Secondary Outcome ◽  
Controlled Study ◽  
Double Blind ◽  
Lidocaine Group ◽  
Double Blind Placebo ◽  
Significant Difference ◽  
Pediatric Colonoscopy

Abstract Background: Propofol is commonly used for providing procedural sedation during pediatric colonoscopy. Intravenous (i.v.) lidocaine can mitigate visceral pain and reduce propofol requirements during surgery. The aim of this study is to investigate the effect of intravenous lidocaine on perioperative propofol and sufentanil dose, pulse oxygen saturation, postoperative pain score, and recovery time during pediatric colonoscopy.Methods: We designed a randomized double-blind placebo-controlled study and enrolled 80 children aged from 3 to 10 years old who underwent colonoscopy. After titration of propofol to achieve unconsciousness, the patients were given i.v. lidocaine (1.5 mg/kg then 2 mg/kg/h) or the same volume of saline. Sedation was standardized and combined propofol with sufentanil. The primary outcome variables were intraoperative propofol and sufentanil requirements, and the number of oxygen desaturation episodes. Secondary outcome variables were recovery time after colonoscopy and post-colonoscopy pain.Results: Lidocaine infusion resulted in a significant reduction in propofol requirements: (median (quartile) 1.8 (1.5-2.0) vs. 3.0 (2.8-3.3) mg/kg respectively; P<0.001) and sufentanil requirements: (median (quartile) 0.06 (0.05-0.08) vs. 0.1 (0.1-0.1) μg/kg respectively; P<0.001). The number of subjects who experienced oxygen desaturation below 95% in the lidocaine group was also significantly less than that in the control group: 2 vs. 8 (P=0.04). The mean (SD) recovery time was significantly shorter in the lidocaine group: (19.2 (2.6) vs. 13.3 (2.6) min respectively; P<0.001). There was no significant difference regarding post-colonoscopy pain.Conclusion: Continuous infusion of lidocaine resulted in reduction in propofol and sufentanil dose requirements, recovery time, and risk of hypoxemia during pediatric colonoscopy.Trial Registration: Chinese Clinical Trials Registry, ChiCTR2000028927, January 8, 2020, prospectively registered.

scholarly journals Use of intravenous lidocaine for dose reduction of propofol in paediatric colonoscopy patients: a randomised placebo-controlled study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenshui Yao ◽  
Longxin Zhang ◽  
Guolin Lu ◽  
Jing Wang ◽  
Li Zhang ◽  
...  
Keyword(s):  
Visceral Pain ◽  
Controlled Study ◽  
Control Group ◽  
Intravenous Lidocaine ◽  
Lidocaine Group ◽  
The Awakening ◽  
Initial Plasma ◽  
Cardiopulmonary Complications ◽  
Recovery Times ◽  
Index Value

Abstract Background Propofol, a widely used sedative in endoscopic procedures, sometimes causes cardiopulmonary complications. Intravenous lidocaine can diminish visceral pain and decrease the dose of propofol. The purpose of this study was to assess the efficacy and safety of intravenous lidocaine in reducing propofol dosage during paediatric colonoscopy. Methods Forty children who underwent colonoscopy were divided into two groups. Lidocaine hydrochloride (1.5 mg/kg induction and 2 mg/kg/h maintenance) was given intravenously to the lidocaine group, and the same amount of saline was given to the control group after they received lidocaine induction. Propofol initial plasma concentration of 5 μg/mL was targeted, and the procedure was performed after the bispectral index value reached 55. The primary outcome was propofol requirement. Results The propofol requirement in the lidocaine group was decreased by 35.5% (128.6 ± 30.4 mg vs. 199.4 ± 57.6 mg; p < 0.001; 95%CI: − 100.60, − 41.02). The incidence of involuntary body movements was significantly lower in the lidocaine group (p = 0.028; OR = 0.17; 95%CI: 0.03, 0.92). The awakening time (p < 0.001; 95%CI: − 7.67, − 5.13) and recovery times (p < 0.001; 95%CI: − 7.45, − 4.35) were significantly lower in the lidocaine group. Pain was significantly less at 30 min and 60 min after the procedure in the lidocaine group (0 [0–4] vs. 3 [0–5], p < 0. 001; 0 [0–2] vs. 1 [0–3], p = 0.001). There was no difference in the incidence of bradycardia, hypotension, or hypoxia between the two groups. Conclusions For colonoscopy procedures in paediatric patients, intravenous lidocaine reduces the amount of propofol needed, provides better sedation and postprocedural pain management, as well as a reduction in recovery time. Trial registration The trial was registered on November 6, 2020 at China Clinical Trials Registration Center (www.chictr.org.cn) ref.: ChiCTR 2,000,039,706.

scholarly journals Double blinded randomized placebo-controlled comparative study between sucralfate ointment and lidocaine ointment after Milligan Morgan hemorrhoidectomy

2017 ◽  
Vol 4 (12) ◽  
pp. 3822
Author(s):  
Yahia Alkhateep ◽  
Abdelmieniem Fareed
Keyword(s):  
Wound Healing ◽  
Postoperative Pain ◽  
Pain Intensity ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
Control Group ◽  
Secondary Outcome Measure ◽  
Lidocaine Group ◽  
Significant Difference ◽  
Double Blinded

Background: Post haemorrhoidectomy pain and delayed wound healing are the most annoying drawbacks to the patients and the surgeons. Topical application of sucralfate or lidocaine may help in reducing postoperative pain and promoting wound healing after Milligan Morgan hemorrhoidectomy.Methods: This study was designed as a single-center double blinded randomized placebo controlled trial at the Department of general Surgery Menoufia University, immediately after Milligan Morgan Hemorrhoidectomy, a total of 150 patients were randomly assigned to receive either 10% Sucralfate ointment, 5% lidocaine ointment or placebo ointment (control group). The primary outcome measure was pain intensity measured by a visual analogue scale at different time points after hemorrhoidectomy and the secondary outcome measure was wound healing.Results: There was no significant difference in age, gender, and number of excised hemorrhoid piles between the two groups. At the 1st ,3rd and 7th days after surgery pain intensity was significantly lower in sucralfate group (4.18±0.82, 3.92±0.72, 3.56±0.67) when compared to lidocaine group (5.06±1.11, 4.70±0.84, 3.93±0.75) and placebo group (6.17±1.26, 5.42±0.98, 4.55±0.84). At the 21st and 28th days no significant difference in pain intensity between groups (p > 0.05) with better wound healing in sucralfate group (P<0.05).Conclusions: Sucralfate was able to reduce the acute postoperative pain and improve wound healing after hemorrhoidectomy, local anesthetic lidocaine could help in pain control but without effect on healing.

scholarly journals Use of Intravenous Lidocaine for Dose Reduction of Propofol in Paediatric Colonoscopy Patients: a Randomised Placebo-controlled Study

2021 ◽  
Author(s):  
Wenshui Yao ◽  
Longxin Zhang ◽  
Guolin Lu ◽  
Jing Wang ◽  
Li Zhang ◽  
...  
Keyword(s):  
Visceral Pain ◽  
Controlled Study ◽  
Control Group ◽  
Intravenous Lidocaine ◽  
Lidocaine Group ◽  
The Awakening ◽  
Initial Plasma ◽  
Cardiopulmonary Complications ◽  
Recovery Times ◽  
Index Value

Abstract Background: Propofol, a widely used sedative in endoscopic procedures, often causes cardiopulmonary complications. Intravenous lidocaine can diminish visceral pain and decrease the dose of propofol. The purpose of this study was to assess the efficacy and safety of intravenous lidocaine in reducing propofol dosage during paediatric colonoscopy.Methods: Forty children who underwent colonoscopy were divided into two groups. Lidocaine hydrochloride (1.5 mg/kg induction and 2 mg/kg/h maintenance) was given intravenously to the lidocaine group, and the same amount of saline was given to the control group after they received lidocaine induction. Propofol initial plasma concentration of 5 μg/mL was targeted, and the procedure was performed after the bispectral index value reached 55. The primary outcome was propofol requirement. Results: The propofol requirement in the lidocaine group was decreased by 35.5% (128.6 ± 30.4 mg vs. 199.4 ± 57.6 mg; p < 0.001; 95%CI: -100.60, -41.02). The incidence of involuntary body movements was significantly lower in the lidocaine group (p = 0.028; OR = 0.17; 95%CI: 0.03, 0.92). The awakening time (p < 0.001; 95%CI: -7.67, -5.13) and recovery times (p < 0.001; 95%CI: -7.45, -4.35) were significantly lower in the lidocaine group. Pain was significantly less at 30 min and 60 min after the procedure in the lidocaine group (0 [0 – 4] vs. 3 [0 – 5], p < 0. 001; 0 [0 – 2] vs. 1 [0 – 3], p < 0.001). The mean lowest blood pressure during the procedure in the control group was significantly lower (p = 0.027; 95%CI: 0.44, 6.86). There was no difference in the incidence of bradycardia, hypotension, or hypoxia between the two groups.Conclusions: For colonoscopy procedures in paediatric patients, intravenous lidocaine reduces the amount of propofol needed, provides better sedation and postprocedural pain management, as well as a reduction in recovery time.Trial registration: The trial was registered on November 6, 2020 at China Clinical Trials Registration Center (www.chictr.org.cn) ref: ChiCTR 2000039706.

scholarly journals Efficacy of intravenous lidocaine infusions for pain relief in children undergoing laparoscopic appendectomy: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maciej Kaszyński ◽  
Dorota Lewandowska ◽  
Piotr Sawicki ◽  
Piotr Wojcieszak ◽  
Izabela Pągowska-Klimek
Keyword(s):  
Laparoscopic Appendectomy ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Control Group ◽  
Intravenous Lidocaine ◽  
Lidocaine Group ◽  
Randomized Controlled ◽  
Fentanyl Consumption

Abstract Intravenous lidocaine, a potent local anesthetic with analgesic and anti-inflammatory properties, has been shown to be an effective adjunct that reduces intra- and postoperative opioid consumption and facilitates pain management in adults. While it shows promise for use in the pediatric population, limited evidence is available. Objectives To determine if general anesthesia with intraoperative intravenous lidocaine infusion versus general anesthesia without intravenous lidocaine infusion in children undergoing laparoscopic appendectomy decreased opioid requirements intra- and postoperatively. Design A single-center parallel single-masked randomized controlled study. A computer-generated blocked randomization list was used to allocate participants. The study was conducted between March 2019 and January 2020. Setting: Pediatric teaching hospital in Poland. Participants Seventy-four patients aged between 18 months and 18 years undergoing laparoscopic appendectomy. Seventy-one patients fulfilled the study requirements. Intervention Intravenous lidocaine bolus of 1.5 mg/kg over 5 min before induction of anesthesia followed by lidocaine infusion at 1.5 mg/kg/h intraoperatively. The infusion was discontinued before the patients’ transfer to the postanesthesia care unit (PACU). Primary outcome measure The primary outcome measure was total nalbuphine requirement in milligrams during the first 24 h after surgery. Secondary outcome measures The secondary outcome measures were intraoperative fentanyl consumption, intraoperative sevoflurane consumption, time to the first rescue analgesic request, incidence of postoperative nausea and vomiting during the first 24 h after surgery, frequency of side effects of lidocaine. Results Children (n = 74) aged 5–17 randomly allocated to receive intraoperative lidocaine infusion (n = 37) or no intervention (n = 37). Seventy-one were included in the analysis (35 in the study group and 36 in the control group). There was no difference in the cumulative dose of nalbuphine in the first 24 h after removal of the endotracheal tube between groups [median of 0.1061 (IQR: 0.0962–0.2222) mg/kg in the lidocaine group, compared to the control group median of 0.1325 (IQR: 0.0899–0.22020) mg/kg, p = 0.63]. Intraoperative fentanyl consumption was lower in the lidocaine group [median of 5.091 (IQR: 4.848–5.714) μg/kg] than in the control group [median of 5.969 (IQR: 5.000–6.748), p = 0.03]. Taking into account the additional doses administered based on clinical indications, the reduction in the requirement for fentanyl in the lidocaine group was even greater [median of 0.0 (IQR: 0.0–0.952) vs 0.99 (IQR: 0.0–1.809) μg/kg, p = 0.01]. No difference was observed in the sevoflurane consumption between the two groups [median of 32.5 ml (IQR 25.0–43.0) in the lidocaine group vs median of 35.0 ml (IQR: 23.5–46.0) in the control group, p = 0.56]. The time to first analgesic request in the lidocaine group was prolonged [median of 55 (IQR: 40–110) min in the lidocaine group vs median of 40.5 (IQR: 28–65) min in the control group, p = 0.05]. There was no difference in the frequency of PONV between the two groups (48.57% in the lidocaine group vs 61.11% in the control group, p = 0.29). No lidocaine related incidence of anaphylaxis, systemic toxicity, circulatory disturbances or neurological impairment was reported, during anesthesia or postoperative period. Conclusions Intraoperative systemic lidocaine administration reduced the intraoperative requirement for opioids in children undergoing laparoscopic appendectomy. This effect was time limited, and hence did not affect opioid consumption in the first 24 h following discontinuation of lidocaine infusion. Trial registration NCT03886896.

scholarly journals Cannula complications using elastomeric infusers in Hospital in the Home

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Damian Ryan ◽  
Jennifer Miller ◽  
Joanne Campbell
Keyword(s):  
Patient Satisfaction ◽  
Patient Characteristics ◽  
Secondary Outcome ◽  
Controlled Study ◽  
Patient Acceptance ◽  
Control Group ◽  
Complication Rates ◽  
Patient Satisfaction Scores ◽  
Home Service ◽  
Significant Difference

Abstract Objectives Comparison of the short peripheral cannula (SPC) complication rate of patients with cellulitis receiving IV cefazolin via an elastomeric infuser with those receiving twice-daily bolus treatment (control group) in the Hospital in the Home service. Methods A randomized controlled study using elastomeric infuser versus bolus delivery of IV cefazolin via an SPC of patients referred to the Hospital in the Home service in the Northern Illawarra for treatment of cellulitis. A total of 104 patients were enrolled during the time period of May 2018 to January 2019. Primary outcome measures were SPC complications including phlebitis with a secondary outcome of patient satisfaction. Results A total of 104 patients enrolled. After randomization there were 60 in the infuser group and 44 in the bolus group. Patient characteristics of age, gender, weight and mobility were similar for the two groups. There was no statistically significant difference between the groups for the endpoint of cannula complication rates. Patient satisfaction scores showed patient acceptance of both forms of treatment. Conclusions This study suggests that using elastomeric infusers to deliver cefazolin via a short peripheral IV catheter has similar complication rates to traditional bolus delivery. Patients surveyed showed high levels of satisfaction with both forms of antibiotic delivery.

scholarly journals Comparison of lidocaine, huffing maneuver and combination of both in prevention fentanyl induced cough before induction of anesthesia: a double-blind, prospective, randomized placebo-controlled study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Laleh Dehghanpisheh ◽  
Mohammadhossein Eghbal ◽  
Fatemeh Bagheri Baravati ◽  
Pooya Vatankhah
Keyword(s):  
Controlled Trial ◽  
Intervention Group ◽  
Controlled Study ◽  
Control Group ◽  
Placebo Control ◽  
Anesthesia Induction ◽  
Double Blind ◽  
Lidocaine Group ◽  
Cough Reflex ◽  
Significant Difference

Abstract Background Intravenous bolus injection of fentanyl has been frequently reported to be associated with cough reflex during patient anesthesia. However, the search for the most effective protocol continues. This study aimed to compare the effect of reducing cough reflex after injection of fentanyl in a fusion protocol by combining the injections of lidocaine and Huffing maneuver and comparing with a placebo control group, before anesthesia induction. Methods This prospective randomized controlled trial study was performed on 400 patients who were divided into four groups of combined protocol (group 1), lidocaine group (group 2), Huffing maneuver group (group 3), and the control receiving normal saline (group 4). Then patients were injected with 2. 5 μg /kg fentanyl and monitored for 2 min regarding their cough reflex, as well as the severity. Results In group one, 9 patients (9%), in group two, 45 patients (45%), 22 patients (22%) in group three, and in group four, 75 patients (75%), developed cough reflex following fentanyl injection. Also, 13 patients (13%) developed moderate and 4 (4%) developed severe coughs in the control group reported, while no reports of severe or moderate cough were among the intervention groups. There was a significant difference between the intervention group and the control group both in terms of the rate and severity of the fentanyl-induced cough. Conclusion By using a combination of lidocaine injection along and Huffing maneuver, better results can be obtained in reducing the frequency, and also the severity of cough followed by fentanyl injection. Trial registration The trial was registered with IRCT.IR (09/03/2018-No. IRCT20141009019470N74).

scholarly journals Donepezil for mild cognitive impairment in Parkinson’s disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kyoungwon Baik ◽  
Seon Myeong Kim ◽  
Jin Ho Jung ◽  
Yang Hyun Lee ◽  
Seok Jong Chung ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Treatment Group ◽  
Outcome Measures ◽  
Rating Scale ◽  
Secondary Outcome ◽  
Control Group ◽  
Significant Difference

AbstractWe investigated the efficacy of donepezil for mild cognitive impairment in Parkinson’s disease (PD-MCI). This was a prospective, non-randomized, open-label, two-arm study. Eighty PD-MCI patients were assigned to either a treatment or control group. The treatment group received donepezil for 48 weeks. The primary outcome measures were the Korean version of Mini-Mental State Exam and Montreal Cognitive Assessment scores. Secondary outcome measures were the Clinical Dementia Rating, Unified Parkinson’s Disease Rating Scale part III, Clinical Global Impression scores. Progression of dementia was assessed at 48-week. Comprehensive neuropsychological tests and electroencephalography (EEG) were performed at baseline and after 48 weeks. The spectral power ratio of the theta to beta2 band (TB2R) in the electroencephalogram was analyzed. There was no significant difference in the primary and secondary outcome measures between the two groups. However, the treatment group showed a significant decrease in TB2R at bilateral frontotemporoparietal channels compared to the control group. Although we could not demonstrate improvements in the cognitive functions, donepezil treatment had a modulatory effect on the EEG in PD-MCI patients. EEG might be a sensitive biomarker for detecting changes in PD-MCI after donepezil treatment.

scholarly journals Effect of pelvic laparoscopic implantation of neuroprosthesis in spinal cord injured subjects: a 1-year prospective randomized controlled study

Spinal Cord ◽  
2021 ◽  
Author(s):  
Helge Kasch ◽  
Uffe Schou Løve ◽  
Anette Bach Jønsson ◽  
Kaare Eg Severinsen ◽  
Marc Possover ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Outcome Measures ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
Controlled Study ◽  
Control Group ◽  
Walking Ability ◽  
Data Set ◽  
Cord Injury

Abstract Study design 1-year prospective RCT. Objective Examine the effect of implantable pulse generator and low-frequency stimulation of the pelvic nerves using laparoscopic implantation of neuroprosthesis (LION) compared with neuromuscular electrical stimulation (NMES) in SCI. Methods Inclusion criteria: traumatic spinal cord injury (SCI), age 18–55 years, neurological level-of-injury Th4–L1, time-since-injury >1 year, and AIS-grades A–B. Participants were randomized to (A) LION procedure or (B) control group receiving NMES. Primary outcome measure: Walking Index for Spinal Cord Injury (WISCI-II), which is a SCI specific outcome measure assessing ability to ambulate. Secondary outcome measures: Spinal Cord Independence Measure III (SCIM III), Patient Global Impression of Change (PGIC), Penn Spasm Frequency Scale (PSFS), severity of spasticity measured by Numeric Rating Scale (NRS-11); International Spinal Cord Injury data sets-Quality of Life Basic Data Set (QoLBDS), and Brief Pain Inventory (BPI). Results Seventeen SCI individuals, AIS grade A, neurological level ranging from Th4–L1, were randomized to the study. One individual was excluded prior to intervention. Eight participants (7 males) with a mean age (SD) of 35.5 (12.4) years were allocated to the LION procedure, 8 participants (7 males) with age of 38.8 (15.1) years were allocated to NMES. Significantly, 5 LION group participants gained 1 point on the WISCI II scale, (p < 0.013; Fisher´s exact test). WISCI II scale score did not change in controls. No significant changes were observed in the secondary outcome measures. Conclusion The LION procedure is a promising new treatment for individuals with SCI with significant one-year improvement in walking ability.

scholarly journals A preliminary study of bowel rest strategy in the management of Clostridioides difficile infection

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hiroshi Sugimoto ◽  
Ayaka Yoshihara ◽  
Takao Yamamoto ◽  
Keisuke Sugimoto
Keyword(s):  
Secondary Outcome ◽  
Control Group ◽  
Matched Cohort ◽  
Full Cohort ◽  
Clostridioides Difficile ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Clostridioides Difficile Infection ◽  
Bowel Rest ◽  
Preliminary Study

AbstractClostridioides difficile infection (CDI) is an important nosocomial infection and is the leading cause of infectious diarrhea in hospitalized patients. We aimed to assess the effect of bowel rest on the management of CDI. A single-center retrospective cohort study was conducted. The primary outcome was the composite of the all-cause mortality and CDI recurrence within 30 days. The main secondary outcome was switching from metronidazole to vancomycin. Of the 91 patients with CDI enrolled as the full cohort, 63 patients (69%) and 28 patients (31%) constituted the control group and the bowel rest group, respectively. After one-to-one propensity score matching, a total of 46 patients were included as the matched cohort. In the full cohort, the composite outcome occurred in 19.0% and 14.3% of the patients in the control and the bowel rest group, respectively (p = 0.768). In the matched cohort, it was 17.4% in each group. Although there was no statistically significant difference, the trend of switching was lower in the bowel rest group. The bowel rest may not affect the all-cause mortality and CDI recurrence within 30 days. However, in those prescribed bowel rest, switching from metronidazole to vancomycin may reduce.

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