Clostridium difficile infection prevention: Difference between revisions

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{{Clostridium difficile}}
{{Siren|Clostridium difficile infection}}
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{{Clostridium difficile infection}}
{{CMG}}; {{AE}} {{YD}}
 
==Overview==
There are no vaccines available for the prevention of ''C. difficile'' infection. Individuals in healthcare settings may reduce the risk of ''C. difficile'' infection by washing hands using soap and water (alcohol-based products are not effective), minimizing unnecessary use of antibiotic administration, and properly isolating infected patients with adequate post-discharge room disinfection.


==Prevention==
==Prevention==
The most effective method for preventing ''Clostridium difficile associated diarrhea'' (CDAD) is proper antimicrobial prescribing. In the hospital setting, where CDAD is most common, nearly all patients who develop CDAD are exposed to antimicrobials. Although this sounds easy to do, approximately 50% of antimicrobial use is considered inappropriate. This is consistent whether in the hospital, clinic, community, or academic setting. Several studies have demonstrated a decrease in CDAD by limiting antibitoics most strongly associated with CDAD or by limiting unnecessary antimicrobial prescribing in general, both in outbreak and non-outbreak settings.
There are no vaccines available for the prevention of ''C. difficile'' infection.<ref name="pmid25875259">{{cite journal| author=Leffler DA, Lamont JT| title=Clostridium difficile infection. | journal=N Engl J Med | year= 2015 | volume= 372 | issue= 16 | pages= 1539-48 | pmid=25875259 | doi=10.1056/NEJMra1403772 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25875259  }} </ref> The following prevention strategies have demonstrated significant reduction in the rate of ''C. difficile'' infections<ref name="pmid25875259">{{cite journal| author=Leffler DA, Lamont JT| title=Clostridium difficile infection. | journal=N Engl J Med | year= 2015 | volume= 372 | issue= 16 | pages= 1539-48 | pmid=25875259 | doi=10.1056/NEJMra1403772 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25875259  }} </ref>:
 
*Use soap and water for hand wash in healthcare settings (alcohol-based products are not effective)
Infection control measures, such as wearing gloves when caring for patients with CDAD, have been proven to be effective at preventing CDAD. This works by limiting the spread of ''C. difficile'' in the hospital setting.
*Minimize unnecessary antiobitic administration among hospitalized patients
 
*Isolate hospitalized patients diagnosed with ''C. difficile'' infection
Treatment with various oral supplements containing live bacteria has been studied in efforts to prevent ''Clostridium difficile''-associated infection/disease.  A [[randomized controlled trial]] using a probiotic drink containing ''Lactobacillus casei'', ''L bulgaricus'', and ''Streptococcus thermophilus'' was reported to have some efficacy. This study was sponsored by the company that produces the drink studied <ref name="pmid17604300">{{cite journal |author=Hickson M, D'Souza AL, Muthu N, ''et al'' |title=Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial |journal=BMJ |volume=335 |issue=7610 |pages=80 |year=2007 |pmid=17604300 |doi=10.1136/bmj.39231.599815.55}}</ref>. Although intriguing, several other studies have been unable to demonstrate any benefit of oral supplements of similar bacteria at preventing CDAD. Of note, patients on the antibiotics most strongly associated with CDAD were excluded from this study.
*Disinfect hospital rooms post-discharge
*Consider using probiotics to prevent ''C. difficile'' colonization (controversial with mixed results but may be helpful)


==References==
==References==
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[[Category:Disease]]
[[Category:Disease]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Infectious disease]]
 
[[Category:Bacterial diseases]]
[[Category:Bacterial diseases]]
[[Category:Needs overview]]

Latest revision as of 17:26, 18 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.

Overview

There are no vaccines available for the prevention of C. difficile infection. Individuals in healthcare settings may reduce the risk of C. difficile infection by washing hands using soap and water (alcohol-based products are not effective), minimizing unnecessary use of antibiotic administration, and properly isolating infected patients with adequate post-discharge room disinfection.

Prevention

There are no vaccines available for the prevention of C. difficile infection.[1] The following prevention strategies have demonstrated significant reduction in the rate of C. difficile infections[1]:

  • Use soap and water for hand wash in healthcare settings (alcohol-based products are not effective)
  • Minimize unnecessary antiobitic administration among hospitalized patients
  • Isolate hospitalized patients diagnosed with C. difficile infection
  • Disinfect hospital rooms post-discharge
  • Consider using probiotics to prevent C. difficile colonization (controversial with mixed results but may be helpful)

References

  1. 1.0 1.1 Leffler DA, Lamont JT (2015). "Clostridium difficile infection". N Engl J Med. 372 (16): 1539–48. doi:10.1056/NEJMra1403772. PMID 25875259.

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