Related Experiment Video

Updated: Nov 24, 2025

Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
07:06

Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection

Published on: December 8, 2014

27.4K

Are Antimotility Agents Safe for Use in Clostridioides difficile Infections? Results From an Observational Study in

Carla Kuon1, Rae Wannier1, David Sterken1

  • 1Division of Hospital Medicine, University of California, San Francisco, San Francisco.

Mayo Clinic Proceedings. Innovations, Quality & Outcomes
|December 28, 2020
PubMed
Abstract

Insights

Antimotility agents (AAs) are safe for patients with hematologic malignancies and Clostridioides difficile infection (CDI). Adding AAs to standard antimicrobial therapy did not increase gastrointestinal complications in this patient group.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Pharmacology

Background:

  • Clostridioides difficile infection (CDI) is a significant concern in immunocompromised patients, particularly those with hematologic malignancies.
  • Antimotility agents (AAs) are sometimes used to manage diarrhea but their safety in the context of CDI in this vulnerable population requires careful evaluation.

Purpose of the Study:

  • To assess the safety and outcomes of using antimotility agents (AAs) in patients with hematologic malignancies experiencing Clostridioides difficile infection (CDI).
  • To determine if AA use is associated with increased gastrointestinal complications in hospitalized patients with concurrent hematologic malignancy and CDI.

Main Methods:

  • Retrospective electronic health record review of patients with hematologic malignancies and positive CDI stool assays between April 2012 and September 2017.
  • Chart review to collect data on AA use, timing, and subsequent gastrointestinal complications.

Main Results:

  • Out of 339 CDI patients, 94 (27%) received AAs. All patients received appropriate CDI antimicrobial therapy within 24 hours.
  • The incidence of adverse gastrointestinal events was similar between patients who received AAs (2 events) and those who did not (6 events).
  • Adjusted odds ratio for adverse events was 0.36 (95% CI, 0.06 to 2.10), indicating no significant difference in risk. Early AA use (<48 hours) was also not associated with increased adverse effects.

Conclusions:

  • The use of antimotility agents (AAs) in patients with hematologic malignancies and concurrent Clostridioides difficile infection (CDI) did not lead to an increased incidence of gastrointestinal events.
  • Adding AAs to standard antimicrobial therapy for CDI in this high-risk population appears to be safe and does not pose additional risks.
Keywords:
AA, antimotility agentCDI, Clostridioides difficile infectionEHR, electronic health recordHSCT, hematopoietic stem cell transplantICD-10, International Statistical Classification of Diseases, Tenth RevisionICD-9, International Classification of Diseases, Ninth RevisionIDSA, Infectious Disease Society of AmericaRR, relative riskUCSF, University of California, San Francisco

More Related Videos

A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment12:58

A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment

Published on: May 25, 2017

9.2K
Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R2029106:51

Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R20291

Published on: December 10, 2016

12.9K

Related Concept Videos

Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents01:18

Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents

Acute diarrhea, a common gastrointestinal disturbance, is characterized by the rapid evacuation of fluid stools, leading to an excessive weight in fluid. This condition typically arises from disorders affecting intestinal water and electrolyte transport. It can be triggered by an increased osmotic load within the intestine, excessive secretion of electrolytes and water, mucosal exudation of protein and fluid, or altered intestinal motility. The primary risks of acute diarrhea are dehydration...
310
Drugs Affecting GI Tract Motility: Adsorbents as Antidiarrheal Agents01:20

Drugs Affecting GI Tract Motility: Adsorbents as Antidiarrheal Agents

Diarrhea is characterized by the occurrence of frequent, watery bowel movements. Various factors can trigger diarrhea, including viral or bacterial infections, foodborne illnesses, side effects from certain medications, and underlying digestive disorders. If not adequately managed, diarrhea can lead to complications such as dehydration, electrolyte imbalances, and nutrient deficiencies. Severe diarrhea can lead to significant weight loss, malnutrition, and weakened immune function.
Adsorbents...
436
Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents01:17

Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents

Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
469
Drugs that Destabilize Microtubules01:10

Drugs that Destabilize Microtubules

Microtubules are dynamic structures and can be regulated by microtubule targeting agents (MTAs). Microtubule destabilizing drugs are a class of MTAs that destabilize and prevent microtubules' polymerization. Both natural and synthetic chemicals can be found under this class of drugs. Vincristine and vinblastine, two vinca alkaloids, and colchicine were among the first to be discovered. These drugs can affect cells in various ways, either by inducing a change in cell morphology, preventing...
2.2K
Drugs that Stabilize Microtubules01:15

Drugs that Stabilize Microtubules

Microtubules are dynamic structures that undergo cycles of catastrophe and rescue. The microtubules play a central role in cell division by forming the spindle apparatus for segregating the chromosomes. This makes them ideal targets for regulating dividing cells in tumors and malignant cancer cells. Microtubule stabilizing drugs help stabilize the microtubule formation and promote its polymerization. Paclitaxel was the first microtubule stabilizing agent used as anticancer drug in chemotherapy...
2.4K
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
327