RESUMO
Updated Clostridioides difficile infection (CDI) guidelines published in 2018 recommend vancomycin as first-line treatment. Of 833 community-onset CDI cases in metropolitan Atlanta, Georgia in 2018, over half did not receive first-line treatment, although guideline adherence increased over the year. Second-line treatment was more common in patients treated in ambulatory settings.
Assuntos
Antibacterianos/uso terapêutico , Clostridioides difficile/efeitos dos fármacos , Infecções por Clostridium/tratamento farmacológico , Infecções Comunitárias Adquiridas/tratamento farmacológico , Adulto , Idoso , Antibacterianos/normas , Clostridioides difficile/fisiologia , Infecções por Clostridium/microbiologia , Estudos de Coortes , Infecções Comunitárias Adquiridas/microbiologia , Feminino , Georgia , Guias como Assunto , Humanos , Masculino , Metronidazol/normas , Metronidazol/uso terapêutico , Pessoa de Meia-Idade , Vancomicina/normas , Vancomicina/uso terapêuticoRESUMO
In total, 13 facilities changed C. difficile testing to reflexive testing by enzyme immunoassay (EIA) only after a positive nucleic acid-amplification test (NAAT); the standardized infection ratio (SIR) decreased by 46% (range, -12% to -71% per hospital). Changing testing practice greatly influenced a performance metric without changing C. difficile infection prevention practice.