Controlling Clostridium difficile infection by a restrictive antibiotic policy
R. P. D. Cooke, MRCP(UK), FRCPath, D. Binyon, MRPharmS, MSc, and S. V. Goddard, RGN
Hospital Pharmacist Vol 7 No 2 p52-54
February 2000 Aim - To assess the long-term effect of a restrictive antibiotic policy on the incidence of Clostridium difficile infection (CDI). Design - Early reporting of restricted antibiotic prescriptions was made by ward- based pharmacists to consultant medical microbiologists, following the hospital antibiotic policy. After discussion with the relevant physician, prescriptions were discontinued if considered inappropriate. The total number of days of restricted and freely available antibiotic treatment per 1,000 inpatient days was calculated using a defined daily dose. The standard error test was used for statistical analysis. CDI was diagnosed by testing liquid stool samples for C difficile toxin A (CDTA) in all inpatients over 60 years, in others on antibiotics or chemotherapy and in those with bloody diarrhoea. Setting - A 650-bed district general hospital providing all acute facilities. Study performed between 1993 and 1998. Outcome measures - Annual incidence of CDI and total treatment days for restricted (and freely available) antibiotics per 1,000 inpatient days, for each year of the study.
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