S0177 Association Between Clostridium difficile Infection and Beta-lactam Allergy

INTRODUCTION: There have been previous studies which suggest that there may be a relationship between allergy to beta-lactam antibiotics and development of clostridium difficile infection. The hypothesis is that once a patient is labeled as allergic to beta lactam antibiotics, they are treated with other antibiotics for infection leading to development of clostridium difficile infection. Here, we aim to study if there is relationship between the beta lactam antibiotics and clostridium difficile infection. METHODS: We conducted a retrospective case control study on patients who were admitted to Unity Hospital, New York. The case was defined as patients who had a positive stool polymerase chain reaction test for Clostridium difficile toxin. Control was defined as a patient who had negative tests. 194 case control pairs were identified based on stool sample collection month. Of these, 4 cases and 1 control were removed from the analysis due to lack of all the information. Chi square analysis was used to analyze the data as described below. RESULTS: The average age of the cases of 77 years. There were 56% females. There were 46% patients who had recent PPI use and 30% of patients used laxative. The various comorbidities in cases were diabetes (45%), congestive heart failure (50%), CKD (29%), cancer (21%). More than 3 bowel movements were present in 97% of the cases. The other symptoms were abdominal pain (44%), nausea (27%), fever (13%) abdominal tenderness (28%) mucous in stool (60%) and blood in stool (7%). IBD was present in 5 cases and 10 controls. There were 152 cases and 141 controls who had recent antibiotics use. Of the total 70 patients who were allergic to penicillin, 30 were found to have clostridium difficile infection. Of the total 313 patients who were not allergic to penicillin, 150 patients were found to have clostridium difficile infection. The odds ratio was 1.5 (P = 0.16). CONCLUSION: In our study there was no association between allergy to beta lactam antibiotics and Clostridium difficile infection as suggested by the previous studies. Larger studies are needed to prove or disapprove these associations.Table 1.: Association between the C difficile infection and Beta lactam allergy