Implementation of a Clostridioides difficile infection (CDI) intervention program at a university referral hospital in Spain was associated with improved management of CDI patients and less use of hospital resources, researchers reported last week in Open Forum Infectious Diseases.
The CDI intervention program implemented at the 900-bed hospital (Hospital A) provides real-time advice from an infectious disease specialist to each patient with a positive CDI test and promotes continuity of care by providing a phone number to contact the specialist. To assess the impact of the program, researchers compared the proportion of patients who were not treated with antibiotics, compliance with clinical guidelines, accessibility to new medications, use of hospital resources, and recurrence and mortality rates at Hospital A and another hospital in the same region without a CDI intervention program (Hospital B).
Avoiding unnecessary antibiotic treatment
During the study period, there were 295 CDI cases identified at Hospital A and 130 identified at Hospital B. At Hospital A, 19.3% of cases were identified as being colonized or having self-limited CDI and avoided unnecessary antibiotic treatment, compared with 11.5% at Hospital B. Hospital A also provided access to novel therapies more frequently (35.3% vs 13%) and adhered more closely to current guidelines (95.8% vs 71.3%) than Hospital B.
Although mortality and recurrence rates did not show a statistically significant difference between the two hospitals, the absence of an intervention program at Hospital B was associated with greater odds of any admission due to recurrence (odds ratio [OR], 4.19; 95% confidence interval [CI], 1.09 to 16.05) and greater odds of visits to the emergency department due to CDI (OR, 8.74; 95% CI, 2.54 to 30.04).
The study authors say the findings suggest oversight of CDI patients by an infectious disease specialist may result in better outcomes and resource management.
"In this study, we observed a greater proportion of patients who did not receive antibiotics because they were evaluated as colonized, better adherence to clinical guidelines, easier access to novel therapies and a decrease in hospital resource utilization," they wrote.