C Diff Drug Stewardship

MIT researchers engineered a strain of bacteria that can help protect the natural flora of the human digestive tract from antibiotics and curb the emergence of antimicrobial resistance.

A research team at the Wyss Institute for Biologically Inspired Engineering at Harvard University and Massachusetts Institute of Technology (MIT), using a synthetic biology approach, has developed an engineered live biotherapeutic product (eLBP) that, when given together with commonly used antibiotics known as beta-lactams (which includes the well-known antibiotic penicillin), protects the gut microbiome from dysbiosis. The study is published in Nature Biomedical Engineering.

“Be antibiotic aware and avoid taking unnecessary antibiotics by following these simple guidelines #cdiff #cdifficile #amr #antibiotics #antibioticaware #antibioticresistance #infectiousdisease #IDtwitter”

Clostridioides difficile is a micro-organism well known to cause pseudomembranous colitis with rare extraintestinal manifestations. We present the case of an elderly male with multiple comorbidities who presented with acute onset of fever/chills and hypotension, found to have polymicrobial ba …

NCT04976829.

Background: Solid organ transplant recipients have several risk factors for peri-operative multi-drug-resistant infection: their immune system is dampened as a result of critical illness and surgical stress that may be further impaired by induction immunotherapy and broad-spectrum anti …

This review aims to summarize current progress in the management of critically ill, using biomarkers as guidance for antimicrobial treatment with a focus on antimicrobial stewardship. Accumulated evidence from randomized clinical trials (RCTs) and observational studies in adults for the biomarker-gu …

Engaging in antimicrobial stewardship programs led to a reduction in antibiotic usage in long-term care facilities, potentially reducing the growing risk of antibiotic resistance.

⁦@DrPaulGastro⁩ - Post #Cdiff antibiotics increase the risk of recurrence! #GMFH2022 pic.twitter.com/1nrdOvRJr4— Sahil Khanna, MBBS, MS, FACG, AGAF (@Khanna_S) March 12, 2022

Trauma patients and patients treated with combination ABX therapy were at an increased risk of C difficile infections.

While orders for C difficile toxin tests dropped significantly, the negative test rates did not differ much in recipients of solid organ transplantations.

Although no orders were blocked based on the responses, this multilevel intervention was associated with a 47% decrease in C. difficile testing without effecting the rate of negative testing. These results suggest that we have achieved significant cost savings, in testing and isolation, without sacr …

Finch Therapeutics' phase 3 trial for a Clostridioides difficile med has been placed on clinical hold by the FDA as the agency requests more information on how the biotech screens the donor-de | Finch Therapeutics' phase 3 trial for a C. difficile med has been placed on clinical hold by the FDA as the agency requests more information on how the biotech screens the donor-derived microbiome therapy for the virus that causes COVID-19.

Long-term care facilities were able to see a reduction in antibiotic starts and days of antibiotic therapy by engaging in an antibiotic stewardship program.

It is well established that the gut microbiota plays an important role in host health and is perturbed by several factors including antibiotics. Antibiotic-induced changes in microbial composition can have a negative impact on host health including reduced microbial diversity, changes in functional …

An increase in pediatric cases of C difficile is linked to use of broad-spectrum antibiotics, recurrent infections, and a growth in highly virulent strains.

Participation in the AHRQ safety program was associated with the development of ASPs that actively engaged clinical staff in the decision-making processes around antibiotic prescriptions in participating LTC facilities. The reduction in antibiotic DOT and starts, which was more pronounced in more en …

nces such as antibiotic or IV fluid overuse. We assessed the impact of a pharmacist and provider facing sepsis early warning systems on timeliness of antibiotic administration and sepsis-related clinical outcomes in our setting. DESIGN: A randomized, controlled quality improvement initiative. SETTING: The main emergency department of an academic, safety-net healthcare system from August to December 2019. PATIENTS: Adults presenting to the emergency department. INTERVENTION: Patients were randomized to standard sepsis care or standard care augmented by the display of a sepsis early warning system–triggered flag in the electronic health record combined with electronic health record–based emergency department pharmacist notification. MEASUREMENTS AND MAIN RESULTS: The primary process measure was time to antibiotic administration from arrival. A total of 598 patients were included in the study over a 5-month period (285 in the intervention group and 313 in the standard care group). Time to antibiotic administration from emergency department arrival was shorter in the augmented care group than that in the standard care group (median, 2.3 hr [interquartile range, 1.4–4.7 hr] vs 3.0 hr [interquartile range, 1.6–5.5 hr]; p = 0.039). The hierarchical composite clinical outcome measure of days alive and out of hospital at 28 days was greater in the augmented care group than that in the standard care group (median, 24.1 vs 22.5 d; p = 0.011). Rates of fluid resuscitation and antibiotic utilization did not differ. CONCLUSIONS: In this single-center randomized quality improvement initiative, the display of an electronic health record–based sepsis early warning system–triggered flag combined with electronic health record–based pharmacist notification was associated with shorter time to antibiotic administration without an increase in undesirable or potentially harmful clinical interventions....

Abstract   Growing evidence has highlighted the potentially significant impact of drug–microbiome interactions on patient care. It is possible that hundreds of drugs alter the composition of the microbiome, including many drugs with non-microbial targets. Drug-induced alteration of the microbiome could increase patients’ risk of dysbiosis, a state of microbiome unbalance that increases the chance of […]

Antibiotic use is significantly associated with hospital-onset Clostridioides difficile infection, according to data taken from a large cohort of U.S.-based acute care hospitals.

Restricted susceptibility reporting of TZP and MEM was associated with a significant increased use of AMC and decreased use of TZP relative to overall antibiotic consumption and significant reduction in ESBL- and CPE-positive K. pneumoniae strains.

Previous use of proton pump inhibitors (p=0.003), fluoroquinolones (p=0.016), and cephalosporins (p=0.026) increased the risk for CDI acquisition. 30d mortality was higher among CDI patients (18%) than controls (9%).AJIC https://t.co/yI3B5meBSC @APIC #cdiff #asp #stewardship— Nurse Epidemiologist and Infection Preventionist (@EmilyGaddam) February 17, 2022

Increasing rates of infection and multidrug-resistant pathogens, along with a high use of antimicrobial therapy, make the intensive care unit (ICU) an ideal setting for implementing and supporting antimicrobial stewardship efforts. Overuse of antimicrobial agents is common in the ICU, as practitione …

Longer courses of AMP after lumbar spine surgery were associated with higher odds of CDI, prolonged hospitalization, and reoperation, but not with lower odds of SSI. However, adherence to the recommended duration of AMP is very low, hinting at a wide evidence-to-practice gap that needs to be address …

The CDI rate was lower compared to other series. The incidence of CO-HCFA-CDI episodes increased, and HO-CDI cases decreased from 2016 to 2018. Risk factors for acquisition and severe infection were similar to those reported in non-cancer populations.