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Curbing antibiotic use reduces rates of community-associated C. difficile
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Researchers found that lowering the number of antibiotics prescribed to adults could also significantly reduce the number of community-associated Clostridium difficile infections in the population.
According to their regression model, a 10% reduction in antibiotic prescription rates among patients aged 20 years and older would result in a 16.8% decrease in community-associated C. difficile infection among adults (95% CI, 6-26.3; P = 0.003).
“Implementation of outpatient interventions to reduce inappropriate antibiotic use could substantially decrease [community-associated C. difficile] rates,” Raymund Dantes, MD, MPH, epidemic intelligence service officer for the CDC’s Division of Healthcare Quality Promotion, and colleagues wrote in Open Forum Infectious Diseases.
Dantes and colleagues analyzed 2011 surveillance data from 33 counties in nine U.S. states participating in the The Emerging Infections Program, an active population- and laboratory-based surveillance program that tracks C. difficile infection in both inpatient and outpatient health care settings. The researchers examined the association between outpatient antibiotic prescribing and C. difficile infection among adults.
Raymund Dantes
They found 5.2 million courses of antibiotics were ordered in 2010, with a rate of 0.73 prescriptions per person. Antibiotic prescribing rates were higher among male and female patients aged older than 65 years (0.91 and 1.02 prescriptions per capita, respectively). Among adults, women were prescribed antibiotics more often than men (0.88 vs. 0.56 prescriptions per capita). The most common prescriptions were for macrolides and penicillins (0.157 and 0.137 per capita, respectively).
According to the researchers, reductions in prescribing penicillins and amoxicillin/clavulanic acid had the greatest impact on community-associated C. difficile infection rates.
“Our study suggests that reductions in [community-associated C. difficile] rates would be an additional benefit of interventions to improve antibiotic use in U.S. outpatient settings,” Dantes and colleagues wrote.
Disclosure: The researchers report no relevant financial disclosures.
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