scholarly journals An evaluation of the impact of antibiotic stewardship on reducing the use of high-risk antibiotics and its effect on the incidence of Clostridium difficile infection in hospital settings

2012 ◽  
Vol 67 (12) ◽  
pp. 2988-2996 ◽  
Author(s):  
M. A. Aldeyab ◽  
M. P. Kearney ◽  
M. G. Scott ◽  
M. A. Aldiab ◽  
Y. M. Alahmadi ◽  
...  
Keyword(s):  
High Risk ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Antibiotic Stewardship ◽  
The Impact

scholarly journals 3442 Among Hospitalized Patients, Cannabis use is Associated with Reduced risk of Clostridium Difficile infection

2019 ◽  
Vol 3 (s1) ◽  
pp. 33-34
Author(s):  
Adeyinka Charles Adejumo ◽  
Terence Ndonyi Bukong
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Hospitalized Patients ◽  
Cannabis Use ◽  
Care Utilization ◽  
P Value ◽  
Adjusted Relative Risk ◽  
Increased Risk ◽  
The Impact ◽  
Reduced Risk

OBJECTIVES/SPECIFIC AIMS: Clostridium Difficile Infection (CDI), a prevalent cause of diarrhea, is the most notorious hospital-acquired infection, resulting in an alarming mortality and health care utilization rates. Herein, we investigate the impact of cannabis use, which is gaining significant legalization for recreational use, on the risk of CDI. METHODS/STUDY POPULATION: We selected adult records (age ≥ 18 years) from the Nationwide Inpatient Sample 2014, and identified cannabis users and other clinical conditions using ICD-9-CM codes. With multivariate logistic modeling, we generated propensity scores for cannabis users and matched them to non-users in a 1:1 ratio (104,936:104,936). We then estimated the adjusted relative risk (aRR) for having CDI using conditional Possion regression models with generalized estimating equations [SAS 9.4]. RESULTS/ANTICIPATED RESULTS: Among the matched hospitalizations (n=209,872), cannabis usage was associated with a reduced incidence of CDI (505.8[464.7-550.6] vs. 694.9[645.8-747.70] per 100,000 hospitalizations), resulting in a 27% reduced risk of CDI (aRR:0.73[0.65-0.81]; p-value:<0.0001). Non-dependent and dependent cannabis users respectively had 22% and 78% reduced likelihood of CDI when compared to non-cannabis users (0.78[0.69-0.90] & 0.22[0.12-0.40]). Furthermore, dependent users had less risk of CDI compared to non-dependent users (0.28[0.16-0.51]). Comparatively, abusive use of other substances like alcohol and tobacco was associated with increased risk for CDI (1.30[1.13-1.49] & 1.24[1.10-1.40]) DISCUSSION/SIGNIFICANCE OF IMPACT: Unlike alcohol and tobacco abuse which are associated with elevated risk for CDI, cannabis use, is related to a decreased risk of CDI amongst hospitalized patients. Further prospective and molecular mechanistic studies are required to elucidate how cannabis impacts CDI.

scholarly journals 2025. Evaluation of the Impact of an Antimicrobial Stewardship Program in a Tertiary Hospital in Northern Italy: Efficacy of a Persuasive Approach on Antibiotics Consumption and Rate of Clostridium difficile Infection

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S679-S680
Author(s):  
Erika Chiari ◽  
Davide Mangioni ◽  
Ester Pollastri ◽  
Liana Signorini ◽  
Giovanni Moioli ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Antimicrobial Stewardship ◽  
Positive Impact ◽  
Epidemiological Data ◽  
Tertiary Hospital ◽  
Northern Italy ◽  
Stewardship Program ◽  
Bed Days ◽  
The Impact

Abstract Background Antimicrobial resistance (AMR) situation in Italian hospitals and regions represents a major public health threat [ECDC, 2017]. Antimicrobial stewardship programs (ASPs), particularly when based on local epidemiology, have been beneficial in optimizing antibiotic therapy as well as reducing hospital rates of Clostridium difficile infection (CDI) and AMR [Akpan MR, Antibiotics 2016].. Methods Our ASP program has been conducted at Spedali Civili General Hospital of Brescia, Northern Italy (1300-bed tertiary hospital), between the beginning of 2016 and the end of 2017. A preliminary analysis of local epidemiological data was performed (Table 1). Seven groups (“districts”) were identified according to microbiological and clinical similarities. This was a persuasive-based ASP. First, we trained physicians on general principles of AS, then guidelines for the management of “difficult-to-handle” infections were drafted based on international guidelines and local microbiological data (Table 2).. Results Here we show the results of pre-ASP (2015) vs. post-ASP (2018) analysis on antibiotic consumption (AC) and CDI rates. AC is expressed in DDD/100 bed-days. The overall hospital AC decreased from 84.31 to 76.84 (−9%), consistently with national recommendations [Italian National Plan against AMR, 2017]. In accordance with the local guidelines developed within our ASP, carbapenem consumption decreased from 5.77 to 4.87 (−16%) and fluoroquinolones (FLQ) from 14.45 to 9.94 (−31%). At the same time piperacillin/tazobactam use increased from 5.53 to 8.46 (53%). 3°–4°G cephalosporins and glycopeptides consumption slightly reduced from 11.78 to 11.42 (−3%) and from 4.07 to 3.83 (−6%), respectively. AC of the different districts involved is reported in Table 3. CDI rates decreased from 0.0434/100 bed-days in 2015 to 0.0315/100 bed-days in 2018 (−27%) (Figure 1). Conclusion Our ASP was a persuasive-based program in a setting of high AMR rates. In the short term, it has shown a positive impact in improving AC (in particular of broad-spectrum antibiotics with a high risk of resistance selection and CDI) and CDI rates. Audits for local guidelines adherence and the evaluation of AC, AMR and CDI rates are ongoing as long-term quality measures for assessing the impact of our ASP. Disclosures All authors: No reported disclosures.

Electronic Clostridium difficile Infection Bundle Reduces Time to Initiation of Contact Precautions

2016 ◽  
Vol 38 (2) ◽  
pp. 242-244 ◽  
Author(s):  
Courtney M. Dewart ◽  
Natalia Blanco ◽  
Betsy Foxman ◽  
Anurag N. Malani
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Infect Control Hosp ◽  
Contact Precaution ◽  
Order Entry ◽  
Contact Precautions ◽  
Computerized Order Entry ◽  
Time To Initiation ◽  
The Impact ◽  
Reduced Time

The impact of computerized order-entry bundles on timing of contact precaution initiation for C. difficile infection (CDI) remains largely unexplored. Implementation of an electronic CDI prevention and management bundle that included an automatic isolation component significantly reduced time to initiation of contact precautions from 33.7 to 22.4 hours.Infect Control Hosp Epidemiol 2016;242–244

The impact of a multidisciplinary clinical review of inpatients with Clostridium difficile infection

2011 ◽  
Vol 63 (6) ◽  
pp. e82-e83
Author(s):  
Katie Hatton ◽  
Nick Cooley ◽  
Elli Demertzi ◽  
Berge Azadian
Keyword(s):  
Clostridium Difficile ◽  
Clinical Review ◽  
Clostridium Difficile Infection ◽  
The Impact
Sign in / Sign up

Export Citation Format

Share Document