Half of patients receiving high risk medications do so for less than a year.
As a tertiary and a referral hospital for the four regions in the Northern part of the country, the NCU at KCMC receives high risk babies delivered within the institution and referrals from other health facilities or from home.
Being a major referral centre and the only tertiary health facility in the middle sector of the country, the hospital receives high risk obstetric referrals which inevitably lead to increased adverse pregnancy outcomes, thus explaining our much higher proportion of stillbirths compared to the national estimate.
Even haemophiliacs who received high-risk clotting drugs were not warned of the dangers for many years - by which time they had unwittingly exposed their partners and family to the risk of infection.
This is still lower than the recurrence rate (34.3%) for subjects treated with vancomycin who then received high-risk CAs during follow-up.
The overall recurrence rate following fidaxomicin treatment was only 51 (13.0%) of 391 but was more than doubled (29.0%) among subjects who received high-risk CAs during follow-up.
Overall, 15.5% of subjects were exposed to ≥1 dose of a high-risk antibiotic; 10.1% received high-risk CAs concurrently with CDI treatment, and 7.9% of subjects evaluable for recurrence received CAs during the follow-up period.
Finally, it is noteworthy that both the day 1 and day 5 models were more 'sensitive' in the Elypse 0 series which includes a high proportion (43%) of 'high-risk' chemotherapy regimens, as compared to the Elypse 1 and CLB-1996, in which 8 and 10% of patients received high-risk regimens.
Some of the protection against recurrence afforded by treatment with fidaxomicin was lost when subjects received high-risk CAs during follow-up, supporting the model that fidaxomicin spares the commensal flora and thereby reduces the risk of regrowth of residual C. difficile.
