C Diff Drug Stewardship

Five medical organizations say it is essential that hospitals establish antimicrobial stewardship programs to prevent Clostridioides difficile (C. difficile) infections.

A study demonstrated patients were frequently prescribed broad-spectrum antibiotics when more narrowly tailored antibiotics were considered the optimal choice.

Abstract The human microbiome plays a critical role in health and disease. The microbiota of the human body undergoes disruptions in critical illness, in part due to alterations in physiology but also as the result of medical interventions, most notably antimicrobial drug administration. Thes …

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"We’re talking about hundreds of thousands of adverse events severe enough that these patients needed additional care from a doctor,” an investigator said.

Researchers compared clinical, safety, and economic outcomes between the use of extended vs standard infusions of piperacillin-tazobactam.

Our 3-component intervention of guideline creation, implementation of an order set, and targeted education was associated with a significant decrease in antipseudomonal antibiotic use in the management of inpatient DFIs. DFIs are common and should be considered as opportunities for syndromic steward …

An evidence-based dynamic order panel, integrated within the electronic medical record, was associated with a reduction in both C. difficile ordering and positive tests in comparison to a best practice advisory, although the impact varied between academic and community facilities.

Problems in #AMS in #TID - no data on patient outcomes. What makes a good measure of a AMS program? Is it #resistance #cdiff #morbidity #readmissions?— NCIC (@NCICancer) March 16, 2023

Rampant misuse of antibiotics through self doctoring can have severe repercussions on the health of people in the vulnerable age group. The majority of coughs, colds or fever that Indians suffer from are due to viral infections. Antibiotics have no effects on them. It is bound to create multiple side effects and can result in

In children with AL undergoing induction therapy, antibiotic prophylaxis may improve the bacterial infection and mortality.

Proton pump inhibitors were associated with a 3-fold increased risk for enteric infection among those with IBD but had a modest absolute risk.

Clostridium difficile: Dentistry's Overlooked Threat. Live CE webinar, supported by @perioprotect. Register: https://t.co/LCkcunhOx4#dentist #dentistry #dental #cdiff #antimicrobialresistance #antibiotics #infectioncontrol #infectionprevention ,#superbugs #cdifficile pic.twitter.com/PMryrCweYw— Dental CE Academy™ (@DentalCEAcademy) March 8, 2023

Proton pump inhibitors were associated with a 3-fold increased risk for enteric infection among those with IBD but had a modest absolute risk.

The investigators also found that PPIs and vonoprazan had equivalent magnitudes of association with CDI in the matched subgroup.

Even in this critically injured patient population thought to be at elevated risk for infectious complications from their midfacial fractures, the rates of infectious complications in those who received antibiotics and those who did not were no different. These results suggest that consideration of …

A free dental continuing education course hosted by Dental CE Academy. After surviving a life threatening Clostridioides difficile infection following a periodontal procedure, our Speaker is now sounding the alarm. Clostridioides difficile is no longer just a board question, it is now considered a urgent public health threat that is under recognized by the dental profession.

We found that both PPIs and vonoprazan were associated with CDI, and the magnitude of the association was comparable. Since vonoprazan is widely available in Asian countries, further studies on the association of its usage with CDI are warranted.

The implementation of a 12-month ASP brought significant clinical and economic results, highlighting the benefits of a multidisciplinary teamwork.

One man's quest to leave heartburn meds behind but also not have rebound heartburn problems.

Antibiotic use was not linked to a decrease in infectious complications in either the unadjusted analysis or the adjusted analysis.

It’s one thing to go on Prilosec to tame heartburn and GERD. It’s an entirely different thing to try to get off it.

The results show female patients were more likely to be diagnosed with any adverse event.

Background Excessive use of antibiotics has been reported during the SARS-CoV-2 pandemic. We evaluated trends in antibiotic use and culture positive Gram-negative (GN)/Gram-positive (GP) pathogens in US hospitalized patients before and during the SARS-CoV-2 pandemic. Methods This multicenter, retrospective study included patients from 271 US facilities with  1-day inpatient admission with discharge or death between July 1, 2019, and October 30, 2021, in the BD Insights Research Database. We evaluated microbiological testing data, antibacterial use, defined as antibacterial use ≥ 24 h in admitted patients, and duration of antibacterial therapy. Results Of 5,518,744 patients included in the analysis, 3,729,295 (67.6%) patients were hospitalized during the pandemic with 2,087,774 (56.0%) tested for SARS-CoV-2 and 189,115 (9.1%) testing positive for SARS-CoV-2. During the pre-pandemic period, 36.2% were prescribed antibacterial therapy and 9.3% tested positive for select GN/GP pathogens. During the SARS-CoV-2 pandemic, antibacterial therapy (57.8%) and positive GN/GP culture (11.9%) were highest in SARS-CoV-2-positive patients followed by SARS-CoV-2-negative patients (antibacterial therapy, 40.1%; GN/GP, pathogens 11.0%), and SARS-CoV-2 not tested (antibacterial therapy 30.4%; GN/GP pathogens 7.2%). Multivariate results showed significant decreases in antibacterial therapy and positive GN/GP cultures for both SARS-CoV-2-positive and negative patients during the pandemic, but no significant overall changes from the pre-pandemic period to the pandemic period. Conclusions There was a decline in both antibacterial use and positive GN/GP pathogens in patients testing positive for SARS-CoV-2. However, overall antibiotic use was similar prior to and during the pandemic. These data may inform future efforts to optimize antimicrobial stewardship and prescribing.

Farah Towfic, PharmD, MBA, RPh, director, CEO Operations, US Pharmacopeia, discusses some of the primary topics impacting pharmacists’ delivery of care and quality this year.

A new diagnostic test, AtBFinder, is rapid, accurate and likely to speed effective antibiotic treatment.

This is the first study to evaluate outpatient prescribing for CDI-indicated antibiotics, and one of the few studies to examine fidaxomicin since its introduction to Canadian formularies. Although causation cannot be inferred from study results, oral vancomycin, and fidaxomicin use has increased in …

A new study from Washington University in St. Louis and The Pew Charitable Trusts analyzing private health insurance claims data found that inappropriate antibiotic prescribing among adults diagnosed with common outpatient upper respiratory infections resulted in close to $69 million in excess health care costs in the U.S. in 2017 ($49.6 million for pharyngitis, and $19.1 million for sinus infection).

We found a correlation between changing the type of test and the way the results were displayed, and reduction in CDI-specific antibiotic use without restricting clinician diagnostic ordering. This strategy may warrant consideration in other conditions where antibiotics are overprescribed, such as u …

Patients who were PCR positive or likely colonized in the two-step era were 20 times less likely to be associated with treatment for CDI, without adversely impacting patient outcomes.