Outpatient antbiotic over-use fueling C. diff in children

January 12th, 2015

The majority of pediatric Clostridium difficile infections occur among children in the general community who recently took antibiotics prescribed in doctor’s offices for other conditions, according to a new study by the Centers for Disease Control and Prevention.

The study showed that 71 percent of the cases of C. difficile infection identified among children aged 1 through 17 years were community-associated—that is, not associated with an overnight stay in a healthcare facility. By contrast, two-thirds of C. difficile infections in adults are associated with hospital stays.

Among the community-associated pediatric cases whose parents were interviewed, 73 percent were prescribed antibiotics during the 12 weeks prior to their illness, usually in an outpatient setting such as a doctor’s office. Most of the children who received antibiotics were being treated for ear, sinus, or upper respiratory infections. Previous studies show that at least 50 percent of antibiotics prescribed in doctor’s offices for children are for respiratory infections, most of which do not require antibiotics.

C. difficile, which causes at least 250,000 infections in hospitalized patients and 14,000 deaths every year among children and adults, remains at all-time high levels. Taking antibiotics is the most important risk factor for developing C. difficile infections for both adults and children. When a person takes antibiotics, beneficial bacteria that protect against infection can be altered or even eliminated for several weeks to months. During this time, patients can get sick from C. difficile picked up from contaminated surfaces or spread from a health care provider’s hands.

Although there have been significant improvements in antibiotic prescribing for certain acute respiratory infections in children, further improvement is greatly needed. In addition, it is critical that parents avoid asking doctors to prescribe antibiotics for their children and that doctors follow prescribing guidelines, the CDC stressed.