C Diff Drug Stewardship

By outlining a structured approach for the development and evaluation of CDS interventions, with focus on end user engagement, efficiency and feasibility, ASP and IP professionals can leverage CDS to enhance IP/ASP quality improvement initiatives aimed to improve antibiotic utilization, diagnostic s …

For many common infectious diseases in both adult and pediatric populations, a significant body of evidence now shows that short-course antimicrobials are just as ...

CDI prevalence increased with the number of antimicrobial classes used in combination. Certain types or combinations of antimicrobials may increase the OR for CDI.

George Sakoulas, MD, offered clinical considerations for treatment selection.

Led by Shruti K. Gohil, MD, MPH, the trials examined how computerized physician order entry prompts can reduce the use of extended-spectrum antibiotics in hospitalized patients while maintaining patient safety.

Intermountain Health researchers have received a grant to address the problem of antibiotic overuse and resistance in urgent care and outpatient clinics. The $356,000 grant from Merck will launch the Intermountain ReSCORE-UC project, which will be a two-year study to better understand how to maintain proper antibiotic prescribing in outpatient settings. The goal is to […]

We present a case of a 50-year-old man with chronic kidney disease (CKD) presenting with acute diarrhea and fever. He was admitted a month prior for COVID-19, where he received antibiotics for radiographic findings of pneumonia and elevated procalcitonin. In the emergency department, his stool sampl …

The winter season is known to be a host for many different viruses

The study was registered on the PROSPERO registry (CRD42023465986).

The pharmacist-driven weekend AMS is an opportunity for pharmacists to intervene and optimize patients' care plans. This initiative demonstrated significant increased AMS-related interventions, promoted judicious antimicrobial use, and contributed to a reduced length of hospital stay. Our findings n …

Background Inflammatory bowel disease (IBD) is a chronic, relapsing condition wherein biologics have improved disease prognosis but introduced elevated infection susceptibility. Vedolizumab (VDZ) demonstrates unique safety advantages; however, a comprehensive systematic comparison regarding the risk of Clostridioides difficile infection (CDI) between vedolizumab and alternative medications remains absent. Method Medline, Embase, Cochrane, and clinicaltrials.gov registry were comprehensively searched. Pooled estimates of CDI proportion, incidence, pooled risk ratio between ulcerative colitis (UC) and Crohn’s disease (CD), vedolizumab and other medications were calculated. Data synthesis was completed in R using the package “meta”. Results Of the 338 studies initially identified, 30 met the inclusion/exclusion criteria. For CDI risk, the pooled proportion was 0.013 (95% CI 0.010–0.017), as well as the pooled proportion of serious CDI was 0.004 (95% CI 0.002–0.008). The comparative pooled risk ratios revealed: UC versus CD at 2.25 (95% CI 1.73–2.92), vedolizumab versus anti-TNF agents at 0.15 (95% CI 0.04–0.63) for UC and 1.29 (95% CI 0.41–4.04) for CD. Conclusion The overall CDI risk in IBD patients exposed to vedolizumab was estimated to be 0.013. An increased risk of CDI was noted in UC patients receiving vedolizumab compared to those with CD. Vedolizumab potentially offers an advantage over anti-TNF agents for UC regarding CDI risk, but not for CD. Trial registration The study was registered on the PROSPERO registry (CRD42023465986).

The study authors say knowledge about antibiotic-related harms will help patients, providers, and antibiotic stewardship programs.

Broad-spectrum antibiotics were associated with increased risk of ADEs among otherwise healthy adults treated for CAP in the outpatient setting. Antimicrobial stewardship is needed to promote judicious use of broad-spectrum antibiotics and ultimately decrease antibiotic-related ADEs.

With few exceptions, treatment can be shortened to 7 days, researcher says

A trial conducted in 7 countries found that a 7-day course of antibiotics for patients with bloodstream infections is non-inferior to a 14-day course.

Hematologic malignancies (HMs), including leukemia, lymphoma, and multiple myeloma, involve the uncontrolled proliferation of abnormal blood cells, posing significant clinical challenges due to their heterogeneity and varied treatment responses. Despite recent advancements in therapies that have imp …

Beta-lactam antibiotics and FQ antibiotics have a profound impact on the gut microbiota in kidney transplant recipients. Given the link of the gut microbiota to infectious complications, antibiotic associated changes in the microbiota may lead to an increased risk for further infections.

Use this handout to explain the basics of why infection prevention and control and antimicrobial stewardship are essential and how the 2 fields must have a unified approach to patient and staff safety

Ertapenem use for perioperative prophylaxis was associated with increased odds of SSI among patients undergoing colon surgery in our study population, though no differences in CDI or clinical CRE culture positivity were identified. Further study and replication of these findings are needed.

The risk of occurrence CDI for hospitalized patients using PPIs for SUP was higher than using H2RAs. It is recommended not to exceed 14 days of any gastric ASDs for SUP during hospitalization, especially for patients who have used high-risk antibiotics, been admitted to the ICU, or have immunodefici …

A preventive strategy based on systematic LTBI screening and moxifloxacin treatment before LT in positive cases appears safe and effective in preventing the development of tuberculosis in LT recipients. However, our findings are limited by a small sample size; thus, larger studies are required to va …

In the period spanning 2017-2021, a mere 12 new antibiotics entered the market, with only one capable of targeting all the pathogens deemed critical by the WHO.

COVID-19 and C. difficile infection were the most common infections following CAR T-cell therapy. Most infections occurred within the first 100 days. Empiric antibiotic use and C. difficile infection were common in patients with CRS/ICANS, in the absence of documented bacterial infection, thus provi …

In this study, cancer patients with a good CRP response during antibiotic therapy presented lower mortality and a higher proportion of satisfactory therapeutic responses. CRP can be a useful tool when combined with other clinical information in optimizing the duration of antimicrobial treatment in a …

Prophylactic antibiotic therapy was an effective and safe treatment for advanced ALD. To mitigate the risk of MDR bacterial infections, a strategy of selective intestinal decontamination could be advisable. Future investigations should prioritize varied ALD patient populations with extended follow-u …

The following is a summary of “Interventional antibiotic treatment replacing antibiotic prophylaxis during allogeneic hematopoietic stem cell transplantation is safe and leads to a reduction of antibiotic administration,” published in the September 2024 issue of Hematology by Toenges et al. Patients undergoing allogeneic hematopoietic stem cell transplantation (alloHSCT) suffer a higher risk of infection-related death,

C diff remains a major healthcare burden globally, with over 225,000 hospitalizations in the US alone. Over half of these cases had recent antibiotic exposure, underlining the significant relationship between antibiotic use and the risk of the healthcare-associated infection.