Direct Prescriber Feedback Following Hospital-Onset Clostridioides difficile Infections
Recommended Citation
Shanahan C, Ruby A, Chami E, Shallal A, Suleyman G. Direct Prescriber Feedback Following Hospital-Onset Clostridioides difficile Infections. Am J Infect Control 2025; 53(6):S15.
Document Type
Conference Proceeding
Publication Date
6-1-2025
Publication Title
Am J Infect Control
Abstract
Background: Hospital-onset Clostridioides difficile infection (HO-CDI) is a major concern in the clinical settings due to its morbidity and persistence within the healthcare environment. Inappropriate antimicrobial use is an important driver for CDI, and incorporation of antimicrobial stewardship (AMS) into CDI initiatives improves utilization of antimicrobials. An AMS program promotes optimal drug selection and duration of antibiotics based on clinical indications. We sought to describe a model for direct prescriber feedback following HO-CDI. Methods: For this 877-bed acute care facility, all HO-CDI in 2024 were reviewed by the Infection Control Medical Director. Cases were reviewed for: CDI treatment method, appropriateness of testing, and opportunities for antimicrobial stewardship within the 8 weeks prior to infection. Beginning in May 2024, feedback letters were sent to prescribing providers via email when AMS opportunities were identified. Results: A total of 43 HO-CDI was reviewed for 2024, of which 22 were reviewed from May to November 2024 for antimicrobial prescribing practices. Feedback letters were sent to prescribing providers in eight cases. In five cases, antibiotics were used without clear evidence of bacterial infection; in three cases, a shorter duration of therapy could have been used, and in three cases, a narrower, lower CDI risk antibiotic would have been more optimal. Responses leading to thoughtful discussion about patient care took place in three (38%) of the eight cases. Conclusions: Through incorporating AMS case review into a CDI program, direct feedback can be given to prescribing providers. This dialogue about optimal drug selection and duration could improve prescribing practices, and thus indirectly impact HO-CDI rates.
Volume
53
Issue
6
First Page
S15
