Using antibiotic stewardship to reduce C. diff infections

January 12th, 2015

Antimicrobial stewardship programs specifically targeting Clostridium difficile infections offer a promising path to protect patients from this enteric scourge, but may have little effect unless a broad range of other infection control measures are also put in place, researchers are finding.

To help infection preventionists consider if antibiotic prescribing patterns are contributing to their C. diff infection rates, the Agency for Healthcare Research and Quality (AHRQ) has created a toolkit outlining how to use ASP to reduce C. diff infections.

For example, reducing inappropriate use of broad spectrum antibiotics like the fluoroquinolones – a worthy goal regardless of other factors -- may thwart the emergence of C. diff in the patient’s gut.

“Antibiotics may kill off some of the ‘good’ bacteria that protects us and basically oppose C. diff,” says Belinda Ostrowsky, MD, MPH, principal clinical investigator for the AHRQ toolkit project and director of the antimicrobial stewardship program at the Montefiore Medical Center in New York City. “The fluoroquinolones in particular have been associated with many outbreaks of this very virulent NAP1 C. diff strain. That strain seems to have more resistance to the quinolones.”

For more on this story see the March 2013 issue of Hospital Infection Control & Prevention.