In a recent micro survey hosted by 3S Consulting Group and featured within the Critical Care Weekly Pulse digital publication, respondents were asked to report trends in the treatment of Clostridium Difficile Infections.
Clostridium difficile, often called C. difficile or C. diff, is a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. Illness from C. difficile most commonly affects older adults in hospitals or in long-term care facilities and typically occurs after use of antibiotic medications. However, studies show increasing rates of C. difficile infection among people traditionally not considered high risk, such as younger and healthy individuals without a history of antibiotic use or exposure to health care facilities.
Approximately 77% of respondents reported that they routinely treat patients infected by C. difficile.
Respondents reported symptoms including watery diarrhea, abdominal cramping and tenderness, fever and increased white blood cell count, with watery diarrhea being the most common symptom reported.
Respondents also reported utilizing the Polymerase chain reaction technique (62%) most often when diagnosing C. diff, followed by the Enzyme immunoassay technique (31%).
Approximately 86% of respondents reported that an antimicrobial stewardship program had been implemented at the healthcare facility where they work.
Clinicians at hospitals with and without antimicrobial stewardship programs reported using Metronidazole (85%) most often when treating patients with C. diff.
However, those with an antimicrobial stewardship program also reported using Vancomycin (80%). For respondents without a stewardship program, the reported utilization of Vancomycin dropped to 61%.
The presence of an antimicrobial stewardship program did not have an overwhelming impact on treatment plans and the broad-spectrum antibiotic, Metronidazole, is utilized most often to treat patients with C. diff. However, it is also interesting to note that those clinicians in hospitals that are implementing antimicrobial stewardship programs reported more use of probiotics, fecal microbiota transplants and Fidaxomicin. Fidaxomicin is a new narrow spectrum antibiotic aimed at treating Clostridium difficile-associated diarrhea (CDAD).
(Hospitals with Antimicrobial Stewardship Programs)
(Hospitals without Antimicrobial Stewardship Programs)