title: Use of intravenous immunoglobulin in severe Clostridium difficile-associated diarrhea.
abstract: OBJECTIVE
  Clostridium difficile infection is an increasingly common cause of healthcare-acquired diarrhea. There remains substantial morbidity and mortality, even with current modalities of treatment. The aim of our study was to investigate the role of intravenous immunoglobulin (IVIG) on mortality in patients with severe Clostridium difficile-associated diarrhea (CDAD).
  
  
  METHODS
  A retrospective chart review of 21 patients with severe CDAD treated with IVIG in our affiliated hospitals from January 2000 to December 2012 was conducted. As a matching control group, we randomly selected 21 patients meeting the definition of severe CDAD from the same period. Data were compared between these groups using appropriate statistical tests.
  
  
  RESULTS
  Patients in the IVIG group were older (69.8 vs 60.9 years, p = 0.05) and had a higher severity score (5.4 vs 3.9, p = 0.02). Mortality was lower among those who received IVIG as compared to the group who did not receive IVIG; however not statistically significant (18.2 vs 22.7%, p = 0.51).
  
  
  CONCLUSIONS
  Our data demonstrate that although the patients who received IVIG had significantly severe infection, there was no difference in the mortality rate. Prospective controlled studies are needed to assess the true benefit of IVIG in patient with severe Clostridium difficle infection.
authors.affiliation: Department of Internal Medicine, Division of Infectious Disease, Baylor College of Medicine , 6620 Main Street, Houston, TX , USA.
authors.forename: Lokesh
authors.initials: L
authors.lastname: Shahani
authors.forename: Janak
authors.initials: J
authors.lastname: Koirala
mesh_terms: D000328:Adult; D000368:Aged; D016360:Clostridioides difficile; D003967:Diarrhea / Q000188:drug therapy* / Q000382:microbiology*; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy* / Q000382:microbiology*; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors
keywords: Clostridium difficile-associated diarrhea; intravenous immunoglobulin