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Many patients with C. difficile received unnecessary antimicrobials
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More than 25% of patients with Clostridium difficile infection received only unnecessary antimicrobials, data from one medical center suggest.
“Although physicians are well aware of antibiotic overuse in the general population, our study demonstrated that this overuse also extends to patients who, because of their current and/or recent C. difficile infection, are at especially high risk for antibiotic complications,” Megan Shaughnessy, MD, of the Minneapolis Veterans Affairs Health Care System and the University of Minnesota, said in an interview with Infectious Disease News.
Megan Shaughnessy
Shaughnessy and colleagues conducted a retrospective review of pharmacy and medical records to determine antimicrobial use for C. difficile infections. The study included patients with new-onset C. difficile infections at the Minneapolis VA Medical Center from 2004 to 2006. Two infectious disease specialists reviewed the records to determine the necessity of antimicrobials used during and after their C. difficile treatment.
The study included 141 patients who received antimicrobials not related to their C. difficile treatment. Of these, 77% of these received at least one dose of unnecessary antimicrobial. In addition, 26% received only unnecessary antimicrobials. There were 2,147 antimicrobial days and 445 antimicrobial courses. The most common reasons for antimicrobial use were urinary tract infections and pneumonia. Fluoroquinolones and beta-lactam antibiotics were the most common unnecessary drugs.
“These data should prompt all physicians to closely evaluate the need for antibiotics in patients with a current and/or past history of C. difficile infection, particularly when treating suspected infections of the urinary and respiratory tracts,” Shaughnessy said.
Megan Shaughnessy, MD, can be reached at megans@umn.edu.
Disclosure: Shaughnessy reports no relevant financial disclosures.
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