C Diff Drug Stewardship

Scientists may be on the verge of developing an antibiotic with fewer side-effects, such as nausea, indigestion, bloating, and diarrhea.

ClinicalTrials.Gov:NCT04291768.

The resources are available on the ADA’s Oral Health Topics webpage on antibiotic stewardship.

For breast cancer patients undergoing breast reconstruction after mastectomy, avoiding postoperative oral antibiotics does not reduce the risk of infections, reports a study in the May issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons.

Proton pump inhibitors (PPIs) are the most commonly prescribed drugs for the treatment of non-erosive reflux disease (NERD), ulcers associated with non-steroidal anti-inflammatory drugs (NSAIDs), esophagitis, peptic ulcer disease (PUD), Zollinger-Ellison syndrome (ZES), gastroesophageal reflux disea …

stems throughout the United States that were contributing to the N3C database. Centers that had fewer than 500 admissions in their dataset were excluded. Patients: Patients hospitalized with COVID-19 were included. Patients were defined to have early antibiotic use if they received at least 3 calendar days of intravenous antibiotics within the first 5 days of admission. Interventions: None. Measurements and Main Results: Of 322,867 qualifying first hospitalizations, 43,089 patients received early empiric antibiotics. Antibiotic use declined across all centers in the data collection period, from March 2020 (23%) to June 2022 (9.6%). Average rates of early empiric antibiotic use (EEAU) also varied significantly between centers (deviance explained 7.33% vs 20.0%, p 0.001). Antibiotic use decreased slightly by day 2 of hospitalization and was significantly reduced by day 5. Mechanical ventilation before day 2 (odds ratio [OR] 3.57; 95% CI, 3.42–3.72), extracorporeal membrane oxygenation before day 2 (OR 2.14; 95% CI, 1.75–2.61), and early vasopressor use (OR 1.85; 95% CI, 1.78–1.93) but not region of residence was associated with EEAU. After propensity matching, EEAU was associated with an increased risk for in-hospital mortality (OR 1.27; 95% CI, 1.23–1.33), prolonged mechanical ventilation (OR 1.65; 95% CI, 1.50–1.82), late broad-spectrum antibiotic exposure (OR 3.24; 95% CI, 2.99–3.52), and late Clostridium difficile infection (OR 1.60; 95% CI, 1.37–1.87). Conclusions: Although treatment of COVID-19 patients with empiric antibiotics has declined during the pandemic, the frequency of use remains high. There is significant inter-center variation in antibiotic prescribing practices and evidence of potential harm. Our findings are hypothesis-generating and future work should prospectively compare outcomes and adverse events....

Antibiotics administered before and during surgery should be discontinued immediately after a patient's incision is closed, according to updated recommendations for preventing surgical site infections. ...

The resources are available on the ADA’s Oral Health Topics webpage on antibiotic stewardship.

Those prepared with bacterial cultures may be useful, but scientific support for their alleged benefits in treating diarrhea, eczema, and ear infections is scarce. We review the data

Proton pump inhibitors (PPIs), although introduced 25 years ago, still find their relevance in modern clinical practice settings and have been widely used in the management of acid-peptic...

Clostridioides difficile infection (CDI) appears to be associated with different liver diseases. C. difficile secretes membrane vesicles (MVs), which may be involved in the development of nonalcoholic fatty liver disease (NALFD) and drug-induced liver injury (DILI). In this study, we i …

Background and Objectives. The intensive care unit (ICU), especially in an infectious disease hospital, is both an area with a high consumption of antibiotics (atb) and a "reservoir" of multidrug-resistant bacteria. We proposed the analysis of antibiotic therapy practices in such a department …

We analyzed efficacy of a centralized surveillance infection prevention (CSIP) program in a healthcare system on healthcare-associated infection (HAI) rates amid the coronavirus disease 2019 (COVID-19) pandemic. HAI rates were variable in CSIP and non-CSIP facilities. Central-line-associated bloodst …

Reducing unnecessary antibiotic prescriptions for viral upper respiratory tract infections is crucial to stop the spread of antimicrobial resistance.

In cancer patients, nosocomial pneumonia was more frequent during the pandemic period. We did not observe a significant impact on other HAIs. MDROs did not significantly increase during the pandemic.

Not only severity of COVID-19 clinical presentation but also worse functional status, referral from other hospitals, certain indications for admission, certain chronic comorbidities, and complications that arise during hospital stay independently reflect on the need of prolonged hospitalization. Dev …

Extended infusion of the antibiotics resulted in fewer patients who died, a shorter length of hospitalization, and lower incidence of C difficile.

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.

Increased age, male sex, COPD, CHF, dependent functional status, and C. difficile infection were associated with increased mortality within 30 days of surgery.

Antibiotics disrupt the normal flora of the gut and can lead to health complications. Pre and probiotics and a well-balanced diet can help prevent complications.

Despite decreases in C. difficile and most MRSA infections, the early COVID-19 pandemic period saw continued increases in MRSA septicemia admissions in North Carolina. Equitable interventions to curb increases and reduce healthcare costs should be developed.

Some drugs and supplements can make your symptoms worse. Find out which are off-limits and what to do or take instead.

The incidence of CDI in the southern area of China was low. Age 60 years, and treatment in geriatric or neurosurgery units were independent risk factors for CDI inpatients.

C. difficile is significant pathogen implicated in AAD with a prevalence rate of 18.4%. GDH antigen detection followed by Toxin A/B ELISA for C. difficile yielded better detection rate as compared to stool culture.

Background Acute abdomen is often complicated by intra-abdominal infection requiring antibiotic therapy. Danish regional antibiotic guidelines emphasize the restricted use of broad-spectrum a...

Background Acute abdomen is often complicated by intra-abdominal infection requiring antibiotic therapy. Danish regional antibiotic guidelines emphasize the restricted use of broad-spectrum a...

Antimicrobial stewardship is 'essential' to prevent C. diff: Updated hospital guidance https://t.co/XDj02hP22O #Cdiff #AntibioticStewardship pic.twitter.com/wvbv07p4ko— MedPro Group (@MedProProtector) April 15, 2023

In-early-2016-the-University-of-Wisconsin-UW-Health-in-Madison-had-the-unenviable-distinction-of-being-in-the-bottom-sixth-percentile-of-U-S-hospitals-in-its

Rapid antibiotic resistance in bacteria is putting pressure on both existing therapies as well as the development pipeline. Here, the authors present a dual-acting anti-virulence treatment that evades antibiotic resistance mechanisms and remains effective against Top Priority pathogens.

Reducing unnecessary antibiotic prescriptions for viral upper respiratory tract infections is crucial to stop the spread of antimicrobial resistance.