PMID- 21809713
OWN - NLM
STAT- MEDLINE
DCOM- 20111102
LR  - 20201209
IS  - 0043-3144 (Print)
IS  - 0043-3144 (Linking)
VI  - 60
IP  - 1
DP  - 2011 Jan
TI  - The management of Clostridium difficile-associated diarrhoea in a community 
      hospital.
PG  - 57-60
AB  - OBJECTIVE: To review the management of patients with Clostridium 
      difficile-associated diarrhoea (CDAD). METHODS: A retrospective study was 
      conducted on 26 patients with clinical symptoms of CDAD and positive tests for C 
      difficile toxins A and/or B in stool samples, over a 12- month period. 
      Demographic and clinical data on the patients including use of proton pump 
      inhibitors (PPI), management of CDAD, and compliance with local Infection 
      Prevention and Control Guidelines were examined. RESULTS: The majority of 
      patients were over 45 years of age (24/26, 92.4%) and 42% (11/26) were over 80 
      years of age. At least 50% (13/26) of the patients had acquired CDAD in hospital, 
      15% (4/26) were community acquired and symptomatic at admission while the onset 
      of diarrhoea following admission to hospital was not documented in 35% (9/26). 
      Three (11%) patients had used PPI. Fifteen per cent (4/26) of patients had no 
      history of previous antibiotic therapy; 40% (10/26) were treated with a 
      cephalosporin, fluoroquinolone or a combination of at least two different classes 
      of antibiotics; one (3%) patient was on augmentin and the antibiotic regime used 
      was not documented in 42% (11/26) who also had previous antibiotic therapy. The 
      conditions for which antibiotics were prescribed could not be ascertained in 58% 
      (15/26) but among the remaining cases antibiotics had been prescribed for urinary 
      tract infection, wound respiratory tract infections and sepsis. Metronidazole 
      (18/26, 70%) was the preferred drug of choice for first line therapy in patients 
      with CDAD. None of the patients in the study received the recommended 10 to 14 
      days of antimicrobial therapy for CDAD. Recurrent CDAD was observed in 40% of 
      those who were treated with metronidazole. The study also showed that there was 
      timely reporting of laboratory results and good compliance with the hospital 
      Infection Prevention and Control Guidelines. CONCLUSION: The findings of this 
      study can be used as a process improvement measure in the management of patients 
      with CDAD.
FAU - Tomkins, K
AU  - Tomkins K
AD  - Department of Quality and Risk, King Edward VII Memorial Hospital, Paget, 
      Bermuda.
FAU - Raynor, J
AU  - Raynor J
FAU - Rothwell, L
AU  - Rothwell L
FAU - DeSilva, J
AU  - DeSilva J
FAU - Wilson, C
AU  - Wilson C
LA  - eng
PT  - Journal Article
PL  - Jamaica
TA  - West Indian Med J
JT  - The West Indian medical journal
JID - 0417410
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Bacterial Agents/*therapeutic use
MH  - *Clostridioides difficile
MH  - Cross Infection/*prevention & control
MH  - Diarrhea/*drug therapy/*microbiology
MH  - Enterocolitis, Pseudomembranous/*drug therapy/*microbiology
MH  - Female
MH  - Guideline Adherence
MH  - Hospitals, Community
MH  - Humans
MH  - Infection Control/*methods
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2011/08/04 06:00
MHDA- 2011/11/04 06:00
CRDT- 2011/08/04 06:00
PHST- 2011/08/04 06:00 [entrez]
PHST- 2011/08/04 06:00 [pubmed]
PHST- 2011/11/04 06:00 [medline]
AID - 1354 [pii]
PST - ppublish
SO  - West Indian Med J. 2011 Jan;60(1):57-60.