Decrease in Nosocomial Clostridium difficile–Associated Diarrhea by Restricting Clindamycin Use

Pear, Suzanne M.; Williamson, Tom H.; Bettin, Kris M.; Gerding, Dale N.; Galgiani, John N.

doi:10.7326/0003-4819-120-4-199402150-00003

Cited by 227 publications

(106 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Pepin and colleagues found that older patients with multiple comorbidities were more likely to develop [7] as were patients treated with proton pump inhibitors [28] or tube feedings [29]. Most have described an association between antibiotics, particularly the use of cephalosporins, clindamycin, or fluoroquinolones and CDAD [7,[30][31][32][33][34]. There were large differences in CDAD cases across hospitals, metropolitan statistical areas, and states.…”

Section: Discussionmentioning

confidence: 99%

“…by reducing normal colonic flora with antibiotics used to treat another infection, followed by patients' inoculation with C. difficile spores [33,34]. Despite the long-held view of CDAD pathophysiology, a recent systematic review investigated the association of antibiotics with CDAD in order to summarize the strength of the evidence for this relationship [37].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Predictors of Clostridium difficile colitis infections in hospitals

et al. 2007

View full text Add to dashboard Cite

Hospital-level predictors of high rates of 'Clostridium difficile-associated disease' (CDAD) were evaluated in over 2300 hospitals across California, Arizona, and Minnesota. American Hospital Association data were used to determine hospital characteristics associated with high rates of CDAD. Significant correlations were found between hospital rates of CDAD, common infections and other identified pathogens. Hospitals in urban areas had higher average rates of CDAD; yet, irrespective of geographic location, hospital rates of CDAD were associated with other infections. In addition, hospitals with 'high CDAD' rates had slower turnover of beds and were more likely to offer transplant services. These results reveal large differences in rates of CDAD across regions. Hospitals with high rates of CDAD have high rates of other common infections, suggesting a need for broad infection control policies. KeywordsArizona, California, clostridium difficile, cross infection, enterocolitis, pseudomembranous, geography, hospitals, humans, Minnesota, risk factors, urban population SUMMARYHospital-level predictors of high rates of ' Clostridium difficile-associated disease ' (CDAD) were evaluated in over 2300 hospitals across California, Arizona, and Minnesota. American Hospital Association data were used to determine hospital characteristics associated with high rates of CDAD. Significant correlations were found between hospital rates of CDAD, common infections and other identified pathogens. Hospitals in urban areas had higher average rates of CDAD ; yet, irrespective of geographic location, hospital rates of CDAD were associated with other infections. In addition, hospitals with 'high CDAD ' rates had slower turnover of beds and were more likely to offer transplant services. These results reveal large differences in rates of CDAD across regions. Hospitals with high rates of CDAD have high rates of other common infections, suggesting a need for broad infection control policies.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Predictors of Clostridium difficile colitis infections in hospitals

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Several studies have shown that restriction of clindamycin use was associated with a reduction in nosocomial CDAD cases (Brown et al, 1990;Pear et al, 1994). Other hospitals' rates of CDAD decreased, by at least 50 %, after restricting cephalosporin use (Ludlam et al, 1999;Khan & Cheesbrough, 2003).…”

Section: Control Of Cdadmentioning

confidence: 99%

Alternative treatments for Clostridium difficile disease: what really works?

McFarland

2005

Journal of Medical Microbiology

141

View full text Add to dashboard Cite

Vancomycin and metronidazole have been used for treating Clostridium difficile-associated disease (CDAD) for the past 25 years, but approximately 20 % of patients develop recurrent disease. The increasing incidence of nosocomial outbreaks, cases of recurrent CDAD and other complications (toxic megacolon, ileus, sepsis) has fuelled the search for different types of treatments. As the understanding of the pathogenesis of this disease has matured, newer treatment strategies that take advantage of these mechanisms have been developed. This review will describe such treatments and examine the evidence for each strategy.

show abstract

“…Initiate an antimicrobial stewardship program (A-II). 22,[25][26][27]32,54,55 a. Assess the appropriateness of antimicrobial prescribing practices.…”

Section: Place Patients With Diarrhea Under Contact Precautions Whilementioning

confidence: 99%

Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals

Dubberke

Gerding

Classen

et al. 2008

Infect. Control Hosp. Epidemiol.

189

194

View full text Add to dashboard Cite

Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections. The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their Clostridium difficile infection (CDI) prevention efforts. Refer to the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America “Compendium of Strategies to Prevent Healthcare-Associated Infections” Executive Summary and Introduction and accompanying editorial for additional discussion.1. Increasing rates of CDIC. difficile now rivals methicillin-resistant Staphylococcus aureus (MRSA) as the most common organism to cause healthcare-associated infections in the United States.a. In the United States, the proportion of hospital discharges in which the patient received the International Classification of Diseases, Ninth Revision discharge diagnosis code for CDI more than doubled between 2000 and 2003, and CDI rates continued to increase in 2004 and 2005 (L. C. McDonald, MD, personal communication, July 2007). These increases have been seen in pediatric and adult populations, but elderly individuals have been disproportionately affected. CDI incidence has also increased in Canada and Europe.b. There have been numerous reports of an increase in CDI severity.c. Most reports of increases in the incidence and severity of CDI have been associated with the BI/NAP1/027 strain of C. difficile. This strain produces more toxins A and B in vitro than do many other strains of C. difficile, produces a third toxin (binary toxin), and is highly resistant to fluoroquinolones.

show abstract

Decrease in Nosocomial Clostridium difficile–Associated Diarrhea by Restricting Clindamycin Use

Abstract: A nosocomial epidemic of C. difficile diarrhea was controlled by analysis of antibiotic use patterns and by subsequent restriction of clindamycin.

Cited by 227 publications

References 0 publications

Predictors of Clostridium difficile colitis infections in hospitals

Predictors of Clostridium difficile colitis infections in hospitals

Alternative treatments for Clostridium difficile disease: what really works?

Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals

Contact Info

Product

Resources

About