C Diff Drug Stewardship

Background Many factors determine empirical antibiotic treatment of community-acquired pneumonia (CAP). We aimed to describe the empirical antibiotic treatment CAP patients with an acute hospital visit and to determine if the current treatment algorithm provided specific and sufficient coverage against Legionella pneumophila, Mycoplasma pneumoniae, and Clamydophila pneumoniae (LMC). Methods A descriptive cross-sectional, multicenter study of all adults with an acute hospital visit in the Region of Southern Denmark between January 2016 and March 2018 was performed. Using medical records, we retrospectively identified the empirical antibiotic treatment and the microbiological etiology for CAP patients. CAP patients who were prescribed antibiotics within 24 h of admission and with an identified bacterial pathogen were included. The prescribed empirical antibiotic treatment and its ability to provide specific and sufficient coverage against LMC pneumonia were determined. Results Of the 19,133 patients diagnosed with CAP, 1590 (8.3%) patients were included in this study. Piperacillin-tazobactam and Beta-lactamase sensitive penicillins were the most commonly prescribed empirical treatments, 515 (32%) and 388 (24%), respectively. Our analysis showed that 42 (37%, 95% CI: 28–47%) of 113 patients with LMC pneumonia were prescribed antibiotics with LMC coverage, and 42 (12%, 95% CI: 8–15%) of 364 patients prescribed antibiotics with LMC coverage had LMC pneumonia. Conclusion Piperacillin-tazobactam, a broad-spectrum antibiotic recommended for uncertain infectious focus, was the most frequent CAP treatment and prescribed to every third patient. In addition, the current empirical antibiotic treatment accuracy was low for LMC pneumonia. Therefore, future research should focus on faster diagnostic tools for identifying the infection focus and precise microbiological testing.

There is a high rate of utilization of non-CDI antibiotics during or shortly after completing CDI treatment with high rates of recurrence within 90-days. Concomitant antimicrobials alter the opportunity for the microbiota to re-grow and worsens dysbiosis leading to increases in recurrence. Concomita …

Scientific Reports - Impact of prolonged carbapenem use-focused antimicrobial stewardship on antimicrobial consumption and factors affecting acceptance of recommendations: a quasi-experimental study

Results from the study found a high risk of CDI associated with clindamycin and low risk associated with doxycycline and minocycline, also highlighting variation in CDI risk within and between classes of antibiotics.

A new study found a higher risk of CDI associated with clindamycin and lower risk associated with doxycycline and minocycline, also highlighting variation in CDI risk within and between classes of antibiotics.

More than 211 million outpatient oral antibiotic prescriptions were written in 2021, according to the CDC. Data show that around 30% of outpatient prescriptions are inappropriate.

Restricting the use of antimicrobials and enhancing infection prevention and control measures are key to addressing the global challenge.

I got C. diff from antibiotics for a sinus infection, and I had diarrhea for 13 days. Ironically, the treatment was another antibiotic, vancomycin.

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Implementation of IAPs in this high-risk HCT population led to reduction in overall antibiotic use without increase in rate of BSI or CD test positivity. The program was well-received by providers.

Bone and joint infections (BJIs) caused by multidrug-resistant gram-negative bacteria are becoming a concern due to limited therapeutic options. Although not approved for these indications, an ever-growing amount of evidence supports the efficacy and safety of ceftazidime-avibactam as a therapy for …

In the five hospitals with complete data, decrease in broad-spectrum antibiotic utilisation rate was followed by decrease in incidence density of antibiotic-resistant organisms. ASP should continue to be nationally funded as a key measure to combat antimicrobial resistance in acute care hospitals.

Most antibiotics are prescribed in ambulatory setting and at least 30% to 50% of these prescriptions are unnecessary. The use of antibiotics when not needed promotes the development of antibiotic resistant organisms and harms patients by placing them at risk for adverse drug events and Clostridioide …

In the five hospitals with complete data, decrease in broad-spectrum antibiotic utilisation rate was followed by decrease in incidence density of antibiotic-resistant organisms. ASP should continue to be nationally funded as a key measure to combat antimicrobial resistance in acute care hospitals.

We found wide variation in CDI risk within and between classes of antibiotics. These findings ordering the level of associated risk across antibiotics can help inform tradeoffs in antibiotic prescribing decisions and stewardship efforts.

Nature Reviews Microbiology - In this Review, de Nies, Kobras and Stracy examine the detrimental effects of antibiotics on the microbiota and the resulting associated infections. They delve into...

These medications can help treat complications and prevent infection after surgery.

A new study suggests patients who use acid reflux medications for several years may have a higher risk of developing dementia compared to people who do not take these drugs.

Background and objective Cardiac surgery is one of the most common surgical procedures globally; its incidence has been on the rise due to the faster pace of population aging thanks to techno...

In this conversation, host Ruchika Talwar is joined by George Koch to discuss the importance of antibiotic stewardship in urology, exploring the reduction of unnecessary antibiotic loads in treating infections like Fournier's gangrene and recurrent UTIs. Dr. Koch emphasizes the careful selection and timing of antibiotics in perioperative prophylaxis and other conditions. Dr. Talwar points out...

Your gut is a lively place. Bacteria of all kinds live in your intestines and, for the most part, help you to thrive. "The gut microbiome is a very complex ecosystem," says Dr. Geoffrey Preidis…

Structural-racism-and-systemic-injustices-inhibit-the-ability-to-have-equitable-healthcare-also-negatively-impacts-antimicrobial-stewardship-according-to-Jacinda

Antibiotics work by either killing the bacteria directly or by inhibiting the growth of bacteria.

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/PRNewswire/ -- Why do nonsteroidal anti-inflammatory drugs (NSAIDs) exacerbate gastrointestinal infections by Clostridioides difficile, the leading cause of...

A recent article in USA Today proclaimed that we are *this* far away from no longer having working antibiotics, a cataclysmic development that would pose "an existential threat for modern medicine."

Correction: Cost-Effectiveness Analysis of Antimicrobial Prescribing in the Treatment of Clostridioides Difficile Infection in England

Nature Reviews Microbiology - In this Review, de Nies, Kobras and Stracy examine the detrimental effects of antibiotics on the microbiota and the resulting associated infections. They delve into...