What question did this study set out to answer?

Investigate and control an in-hospital epidemic of Clostridium difficile-associated diarrhea using molecular strain typing and antimicrobial stewardship.

February 15, 1994Annals of Internal Medicine

Decrease in Nosocomial Clostridium difficile–Associated Diarrhea by Restricting Clindamycin Use

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Authors

SPSuzanne M. PearCarondelet Health Network KBKristine M. BettinUniversity of Minnesota DGDale N. GerdingNorthwestern University

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Implication

Case-control study demonstrates that restricting clindamycin controls epidemic Clostridium difficile in hospitalized patients, highlighting the power of targeted antibiotic stewardship.

Key Points

Investigate and control an in-hospital epidemic of Clostridium difficile-associated diarrhea using molecular strain typing and antimicrobial stewardship.
Conducted concurrent surveillance and retrospective case-control analysis comparing cytotoxin-positive diarrheic patients with non-infected controls at a Veterans Affairs Medical Center.
Typed C. difficile isolates using restriction endonuclease analysis and evaluated pharmacy records to trace hospital-wide and patient-level antibiotic exposures.
Implemented a hospital formulary restriction on clindamycin to evaluate its impact on infection rates.
During the 13-month epidemic period, the monthly incidence of C. difficile infection averaged more than five times the rate of the preceding 21 months.
A specific clonal strain (restriction enzyme analysis type J7) accounted for 59% of stool isolates (34 patients).
Clindamycin use correlated statistically with infection across multiple hospital metrics, and restricting clindamycin use prompted a rapid decline in total infection rates and type J7 organisms.

Cite This Study

Pear et al. (1994) studied this question.

synapsesocial.com/papers/6a7ca64fa42cae215d7cd056 https://doi.org/10.7326/0003-4819-120-4-199402150-00003

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Implication

Case-control study demonstrates that restricting clindamycin controls epidemic Clostridium difficile in hospitalized patients, highlighting the power of targeted antibiotic stewardship.

Decrease in Nosocomial Clostridium difficile–Associated Diarrhea by Restricting Clindamycin Use

Discussion

Member takes

Implication

Key Points

Cite This Study

Decrease in Nosocomial Clostridium difficile–Associated Diarrhea by Restricting Clindamycin Use

Discussion

Member takes

Implication

Key Points

Cite This Study

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