Three faculty from the Division of Gastroenterology and Hepatology (WDOM) – Drs. Charles Maltz, Paul Miskovitz, and Kaveh Hajifathalian – have published a pivotal paper on Clostridium difficile in the Journal of Gastroenterology and Hepatology (July 2020). The paper, “Lactulose may reduce Clostridium difficile-related diarrhea among patients receiving antibiotics,” is a one-year retrospective review of the incidence of Clostridium difficile infection in NewYork-Presbyterian/Weill Cornell Medical Center inpatients.
In the study, some inpatients were receiving antibiotics alone, and some patients received antibiotics with prebiotic lactulose (used to treat hepatic encephalopathy). The authors discovered that those inpatients who received lactulose therapy had a lower rate of Clostridium difficile infection. Specifically, the administration of lactulose may have reduced the incidence of C. difficile-related diarrhea in hospitalized adult patients receiving antibiotics. If borne out by future studies, this key finding will have a profound impact upon the understanding of antibiotic-associated Clostridium difficile infection.
Clostridium difficile is an increasingly frequent community-acquired infection and a significant cause of diarrhea among hospitalized and institutionalized patients. Risk factors for infection include current or recent hospitalization, proton pump inhibitor usage, advanced age, severe illness, and prior C. difficile infection, although antibiotic therapy is the most often implicated causative factor.