Clostridium difficile infection is a significant concern for healthcare institutions, and it may be difficult to identify the best elements for a management and treatment program, according to a study in the Journal of Clinical Pharmacy and Therapeutics.
In the study, researchers assessed the effects a CDI management policy with clinical pharmacy, medical microbiology and infection control involvement had on the concordance in prescribing practices to severity assessment and pharmacological treatment algorithm.
To assess the efficacy of the policy, the researchers compared 141 CDI episodes in the pre-implementation group with 283 post-implementation episodes. They found the overall treatment concordance to the CDI treatment algorithm was achieved in 48 of 141 cases (34 percent) pre-implementation compared with 136 of 283 cases (48.1 percent) post-implementation.
Additionally, the median time to treatment with vancomycin was reduced from five days to one day and the median length of hospital stay decreased from 30 days to 21 days post-implementation. There was no difference, however, in 30-day all-cause mortality.
Ultimately, the researchers concluded a comprehensive CDI management approach should include:
1. Appropriate stakeholder involvement in the development of clinical pathways
2. Education to healthcare workers
3. Prospective audit with intervention feedback
Together, these elements "can ensure patients diagnosed with CDI are optimally managed and prescribed the most appropriate therapy based on CDI disease severity."
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