Evidence map›Paper›PMID 28800598›Full record

ArticlePloS one2017

An in silico evaluation of treatment regimens for recurrent Clostridium difficile infection.

Natalia Blanco, Betsy Foxman, Anurag N Malani, Min Zhang, Seth Walk, Alexander H Rickard, Marisa C Eisenberg

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 90% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Natalia BlancoDepartment of Epidemiology, School of Public Health, University of Michigan. Ann Arbor, Michigan, United States of America.
Betsy FoxmanDepartment of Epidemiology, School of Public Health, University of Michigan. Ann Arbor, Michigan, United States of America.
Anurag N MalaniDepartment of Infection Prevention & Control, Department of Internal Medicine, Division of Infectious Diseases, St. Joseph Mercy Health System, Ann Arbor, Michigan, United States of America.
Min ZhangDepartment of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America.
Seth WalkDepartment of Microbiology and Immunology, College of Letters & Science, Montana State, Bozeman, Montana, United States of America.
Alexander H RickardDepartment of Epidemiology, School of Public Health, University of Michigan. Ann Arbor, Michigan, United States of America.
Marisa C EisenbergDepartment of Epidemiology, School of Public Health, University of Michigan. Ann Arbor, Michigan, United States of America.ORCID http://orcid.org/0000-0003-4221-830X
University of Michigan · USMercy Health System · USMontana State University · US

Funding

Modeling the Effects of the Environment on Enteric Pathogen DynamicsU01GM110712 · NIGMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI EISENBERG, JOSEPH N. S. · 2014 to 2018
$3.0M
NIGMS NIH HHS U01 GM110712
6 · The paper itself

Abstract

backgroundClostridium difficile infection (CDI) is a significant nosocomial infection worldwide, that recurs in as many as 35% of infections. Risk of CDI recurrence varies by ribotype, which also vary in sporulation and germination rates. Whether sporulation/germination mediate risk of recurrence and effectiveness of treatment of recurring CDI remains unclear. We aim to assess the role of sporulation/germination patterns on risk of recurrence, and the relative effectiveness of the recommended tapered/pulsing regimens using an in silico model.

methodsWe created a compartmental in-host mathematical model of CDI, composed of vegetative cells, toxins, and spores, to explore whether sporulation and germination have an impact on recurrence rates. We also simulated the effectiveness of three tapered/pulsed vancomycin regimens by ribotype.

resultsSimulations underscored the importance of sporulation/germination patterns in determining pathogenicity and transmission. All recommended regimens for recurring CDI tested were effective in reducing risk of an additional recurrence. Most modified regimens were still effective even after reducing the duration or dosage of vancomycin. However, the effectiveness of treatment varied by ribotype.

conclusionCurrent CDI vancomycin regimen for treating recurrent cases should be studied further to better balance associated risks and benefits.

Indexed as

Models, StatisticalAnti-Bacterial AgentsBacterial ToxinsClostridioides difficileClostridium InfectionsComputer SimulationDrug Administration ScheduleDrug Dosage CalculationsHumansMicrobial Sensitivity TestsRecurrenceRibotypingSpores, BacterialVancomycinAnti-Bacterial AgentsBacterial ToxinsVancomycin

Identifiers

PMID28800598
PMCPMC5553947
OpenAlexW2742850159

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.