C Diff Drug Stewardship

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.

Background The American Geriatrics Society 2019 Updated Beers Criteria© recommends avoiding scheduled use of proton pump inhibitors (PPIs) for greater than eight weeks in older people because of potential risk of bone loss and fractures and Clostridioides difficile infection. There …

Probiotics have been used for decades to alleviate the negative side-effects of oral antibiotics, but our mechanistic understanding on how they work is so far incomplete. Here, we performed a metag...

Six respiratory infections are among the most common diagnoses for which antibiotics often are inappropriately prescribed, and new research sheds light on the effects, both in increased risk of adverse events and excess health care costs.

Standard infusion group had more patients with P. aeruginosa isolates from blood and respiratory cultures, ICU status at the start of therapy and longer duration of treatment.

Comprehensive, nonoperative management of PFD including pelvic floor muscle training, biofeedback, electrogalvanic stimulation, constipation management, behavioral modification, incontinence devices, and pharmacotherapy including vaginal estrogen is effective in the treatment of women with PFD.

Over the first 2 years of the pandemic, global antibiotic sales increases were linked with rises in COVID-19 cases.

Clostridioides difficile infection (CDI) is common after allogeneic hematopoietic cell transplantation (alloHCT). The determination of incidence, risk factors, and impact of CDI on alloHCT outcomes is an unmet need. The study examines all patients aged 2 years and older who received first alloHCT fo …

As long as I can recall, I have suffered from stomach pain and intense bloating. In 2018, I began my journey of looking for relief to these symptoms which would lead me down the dark road of contracting recurrent, antibiotic resistant C. diff at the young age of 27. I …

The use of levofloxacin was shown to be safe in the induction phase in children with de novo ALL. The use of this medication did not increase the rate of colonization by CPE nor the rate of diarrhea by C. difficile. All adverse reactions were mild and remitted either spontaneously or after switching …

Older age and use of various medications, including antibiotics, proton pump inhibitors, and corticosteroids were associated with a higher risk of developing C difficile infections.

Conflicting evidence exists on the association between consumption of non-steroidal anti-inflammatory drugs (NSAIDs) and symptomatic worsening of inflammatory bowel disease (IBD). We hypothesized t...

Almost one-third of UTI diagnoses and half of treatments in hospitalized patients with NB are inappropriate. Opportunities exist to improve ASB and UTI management in patients with NB to minimize inappropriate antibiotic use.

Over a 4-year period, the antimicrobial stewardship team reviewed all positive (PCR+/Tox+) and indeterminate (PCR+/Tox-) cases with the most responsible physician for classification of patients as infection or colonization. Among 501 indeterminate samples, 213 (43%) were considered to be clinical 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 analyzed our challenging experience with a randomized controlled trial of misoprostol for prevention of recurrent C. difficile. Despite careful prescreening and thoughtful protocol modifications to facilitate enrollment, we closed the study early after enrolling just 7 participants over 3 years. …

: Broad-spectrum antibiotics are associated with antimicrobial resistance, Clostridioides difficile infection, invasive candidiasis, significant disturbance of the gut microbiome and may seriously impact outcomes in children with cancer or undergoing allogenic hematopoietic stem cell transpla …

Hospital lengths of stay, costs, and readmissions were all reduced after implementing an antimicrobial stewardship program.

Hospital lengths of stay, costs, and readmissions were all reduced after implementing an antimicrobial stewardship program.

It’s like the room is glowing & lighting up during important talk on #Cdiff 💩 post #clindamycin Rx by #dentists 🦷just 1 dose can do it! ⁦@PeggyFund⁩ ⁦@OSAPtweets⁩ ⁦@fdiworlddental⁩ ⁦@DentalCEAcademy⁩ ⁦@AmerDentalAssn⁩ ⁦@LBaddour1⁩ pic.twitter.com/z6Ogri5hjW— Debbie Goff (@idpharmd) January 22, 2023