SIDP Stewardship Pearl: The poop on C.diff: Antimicrobial stewardship initiative at a community teaching hospital

The 2016 guideline for implementing an Antimicrobial Stewardship Program (ASP) was recently released for commentary period with plans for final approval from the Infectious Disease Society of America. The guidelines strongly recommend ASP implement interventions designed to reduce the use of antibiotics associated with a high risk of clostridium difficile infection (CDI). Various articles have been published investigating successful interventions for reducing CDI. Such as Climo et al, this group restricted clindamycin use and decreased CDI (P<0.001). Another study by Waqar S and colleagues showed a decrease rate of CDI from 15.38 to 6.92 per 100,000 patient days, by using a multipronged intervention strategy. In September 2015, the CDI team initiated a pilot to evaluate the effectiveness of using a multi-point intervention approach to reduce the number of hospital-onset, incident (HOI) CDI based on the CDC’s National Healthcare Safety Network (NHSN) Lab ID criteria. Further evaluation of the various interventions has been assessed and is described below.