Slide 1: Did you know? Treating a patient with antibiotics is associated with increased rates of which infection in the next patient using that same hospital bed?
Slide 2: Clostridioides difficile infection (CDI)! We all know that CDI in one patient can dramatically increase the rates of CDI in the next patient of that hospital bed, accounting for up to 10% of all CDIs. However…
Slide 3: …in a large study of 200,000 patients, treating a patient with antibiotics was associated with doubled rates of CDI in the subsequent patient in that bed, even after excluding prior CDI in the first patient! This phenomenon has also been corroborated in another study showing that the amount of antibiotics given on a hospital ward is associated with higher CDI rates for patients on that ward, even if those patients are not receiving antibiotics themselves.
Slide 4: How? The hypothesis is that antibiotics cause proliferation of C. difficile colonies, leading to a higher environmental burden of spores even around asymptomatic patients. All of this information should give us further pause when prescribing antibiotics on the wards, regardless of the patient!
- Shaughnessy MK, Micielli RL, Depestel DD, et al. Evaluation of hospital room assignment and acquisition of Clostridium difficile infection. Infect Control Hosp Epidemiol. 2011;32(3):201-6. PMID 21460503.
- Brown K, Valenta K, Fisman D, Simor A, Daneman N. Hospital ward antibiotic prescribing and the risks of Clostridium difficile infection. JAMA Intern Med. 2015;175(4):626-33.PMID 25705994.
- Freedberg DE, Salmasian H, Cohen B, Abrams JA, Larson EL. Receipt of Antibiotics in Hospitalized Patients and Risk for Clostridium difficile Infection in Subsequent Patients Who Occupy the Same Bed. JAMA Intern Med. 2016;176(12):1801-1808. PMID 27723860.
Tags: antibiotics, c difficile, hospital medicine, infectious disease