A Clostridium difficile Infection (CDI) Stewardship Initiative Improves Adherence to Practice Guidelines for Management of CDI

Abstract

A Clostridium difficile infection (CDI) stewardship initiative reduced inappropriate prescription of empirical CDI therapy and improved timeliness of treatment and adherence to clinical practice guidelines for management of CDI. The initiative required minimal resources and could easily be incorporated into traditional antimicrobial stewardship programs.

The burden of healthcare-associated Clostridium difficile infection in a non-metropolitan setting

“…6,8 Although the initial treatment of non-severe HCA-CDI cases predominantly matched guidelines, there was concerning use of oral metronidazole in half of the severe cases (albeit with small numbers). This was similar to previous findings elsewhere, 21 likely resulting from under-recognition of severity criteria. 3,22 HCA-CDI has been associated with increased LOS and hospital costs.…”

How to: diagnose infection caused by Clostridium difficile

“…This selection can be improved by implementing rejection criteria and a strict policy for appropriate testing. Continuous education of physicians and nurses along with monitoring and feedback are also necessary to reduce inappropriate testing [20].…”

Reducing Overutilization of Testing for Clostridium difficile Infection in a Pediatric Hospital System: A Quality Improvement Initiative

“…Development of a hospital-specific, best practice model for appropriate CDI diagnosis and testing is a primary step toward development of a CDI stewardship initiative. 14 Several core components of this initiative, including automatic laboratory declination of nondiarrheal stool specimens submitted for testing, computerized order entry modifications, and access to the evidencebased algorithm, have remained in place after the conclusion of this study. A recent increase in clinicians' requesting of testing on automatically rejected specimens has been observed, and the multidisciplinary team is planning additional interventions to address this issue.…”