Antibiotic stewardship program slashed C. diff infections among children

An antibiotic stewardship program that raised the bar for prescribing antibiotics to hospitalized children cut the rate of Clostridium difficile (C. diff) infections among pediatric patients more than threefold, according to research presented at the IDWeek infectious disease conference.

The stewardship program at the University of California-Davis Children's Hospital, put in place from 2011-2014, also cut antibiotic costs by more than $56,000 per year, from $277,620 to $221,590, according to an announcement.

Under the physician-led program, medical charts were audited three times a week to determine whether antimicrobial prescriptions were appropriate, and authorization from an infectious disease specialist was required before certain restricted broad-spectrum or expensive antibiotics could be prescribed. Both measures contributed to the cost savings and reduction in C. diff infections, researchers found.

Among the interventions recommended when a review determined misuse of antibiotics:

  • Stop unnecessary antibiotics
  • Prescribe a more narrow-spectrum antibiotic
  • Adjust doses
  • Switch from intravenous to oral antibiotics
  • Use less expensive but equally effective antibiotics
  • Extend the length of time on antibiotics or adding other antimicrobial treatments

Prolonged antibiotic use can wipe out good bacteria in the digestive tract, allowing the dangerous C. diff bacterium to multiply, causing severe and sometimes fatal diarrhea. Children in the study ranged in age from 1 to 17, according to the announcement.

Young patients aren't the only group that can benefit from antibiotic stewardship programs. A separate study released last year found that such programs reduced the rate of geriatric patients readmitted for infection from 7.5 percent to 4.5 percent and reduce overall antibiotic use by 27 percent, FierceHealthcare previously reported.

Most hospitals continue to struggle with controlling both C. diff and methicillin-resistant staphylococcus aureus (MRSA), two of the most serious hospital-acquired infections. About 30 percent of 3,000 U.S. hospitals examined by Consumer Reports received the lowest of next-to-lowest scores for C. diff management. About 40 percent received similar scores for managing MRSA infections.

For more:
- read the announcement