Abstract

Guidelines for the severity classification and treatment of Clostridium difficile infection (CDI) were published by Infectious Diseases Society of America (IDSA)/Society for Healthcare Epidemiology of America (SHEA) in 2010; however, compliance and efficacy of these guidelines has not been widely investigated. This present study assessed compliance with guidelines and its effect on CDI patient outcomes as compared with before these recommendations. A retrospective study included all adult inpatients with an initial episode of CDI treated in a single academic center from January 2009 to August 2014. Patients after guideline publication were compared with patients treated in 2009-2010. Demographic, clinical, and laboratory data were collected to stratify for disease severity. Outcome measures included compliance with guidelines, mortality, length of stay (LOS), and surgical intervention for CDI. A total of 1021 patients with CDI were included. Based upon the 2010 guidelines, 42 (28.8%) of 146 patients treated in 2009 would have been considered undertreated, and treatment progressively improved over time, as inadequate treatment decreased to 10.0% (15/148 patients) in 2014 (P = 0.0005). Overall, patient outcomes with guideline-adherent treatment decreased CDI attributable mortality twofold (P = 0.006) and CDI-related LOS by 1.9 days (P = 0.0009) when compared with undertreated patients. Compliance with IDSA/SHEA guidelines was associated with a decreased risk of mortality and LOS in hospitalized patients with CDI.

Original languageEnglish (US)
Pages (from-to)2185-2192
Number of pages8
JournalEpidemiology and Infection
Volume145
Issue number11
DOIs
StatePublished - Aug 1 2017

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Clostridium Infections
Clostridium difficile
Guidelines
Length of Stay
Therapeutics
Mortality
Compliance
Communicable Diseases
Publications
Inpatients
Epidemiology
Retrospective Studies
Demography
Outcome Assessment (Health Care)
Delivery of Health Care

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Infectious Diseases

Cite this

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title = "Compliance with Clostridium difficile treatment guidelines: Effect on patient outcomes",
abstract = "Guidelines for the severity classification and treatment of Clostridium difficile infection (CDI) were published by Infectious Diseases Society of America (IDSA)/Society for Healthcare Epidemiology of America (SHEA) in 2010; however, compliance and efficacy of these guidelines has not been widely investigated. This present study assessed compliance with guidelines and its effect on CDI patient outcomes as compared with before these recommendations. A retrospective study included all adult inpatients with an initial episode of CDI treated in a single academic center from January 2009 to August 2014. Patients after guideline publication were compared with patients treated in 2009-2010. Demographic, clinical, and laboratory data were collected to stratify for disease severity. Outcome measures included compliance with guidelines, mortality, length of stay (LOS), and surgical intervention for CDI. A total of 1021 patients with CDI were included. Based upon the 2010 guidelines, 42 (28.8{\%}) of 146 patients treated in 2009 would have been considered undertreated, and treatment progressively improved over time, as inadequate treatment decreased to 10.0{\%} (15/148 patients) in 2014 (P = 0.0005). Overall, patient outcomes with guideline-adherent treatment decreased CDI attributable mortality twofold (P = 0.006) and CDI-related LOS by 1.9 days (P = 0.0009) when compared with undertreated patients. Compliance with IDSA/SHEA guidelines was associated with a decreased risk of mortality and LOS in hospitalized patients with CDI.",
author = "Crowell, {K. T.} and Julian, {K. G.} and M. Katzman and Berg, {A. S.} and A. Tinsley and Williams, {E. D.} and Koltun, {W. A.} and E. Messaris",
year = "2017",
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TY - JOUR

T1 - Compliance with Clostridium difficile treatment guidelines

T2 - Effect on patient outcomes

AU - Crowell, K. T.

AU - Julian, K. G.

AU - Katzman, M.

AU - Berg, A. S.

AU - Tinsley, A.

AU - Williams, E. D.

AU - Koltun, W. A.

AU - Messaris, E.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Guidelines for the severity classification and treatment of Clostridium difficile infection (CDI) were published by Infectious Diseases Society of America (IDSA)/Society for Healthcare Epidemiology of America (SHEA) in 2010; however, compliance and efficacy of these guidelines has not been widely investigated. This present study assessed compliance with guidelines and its effect on CDI patient outcomes as compared with before these recommendations. A retrospective study included all adult inpatients with an initial episode of CDI treated in a single academic center from January 2009 to August 2014. Patients after guideline publication were compared with patients treated in 2009-2010. Demographic, clinical, and laboratory data were collected to stratify for disease severity. Outcome measures included compliance with guidelines, mortality, length of stay (LOS), and surgical intervention for CDI. A total of 1021 patients with CDI were included. Based upon the 2010 guidelines, 42 (28.8%) of 146 patients treated in 2009 would have been considered undertreated, and treatment progressively improved over time, as inadequate treatment decreased to 10.0% (15/148 patients) in 2014 (P = 0.0005). Overall, patient outcomes with guideline-adherent treatment decreased CDI attributable mortality twofold (P = 0.006) and CDI-related LOS by 1.9 days (P = 0.0009) when compared with undertreated patients. Compliance with IDSA/SHEA guidelines was associated with a decreased risk of mortality and LOS in hospitalized patients with CDI.

AB - Guidelines for the severity classification and treatment of Clostridium difficile infection (CDI) were published by Infectious Diseases Society of America (IDSA)/Society for Healthcare Epidemiology of America (SHEA) in 2010; however, compliance and efficacy of these guidelines has not been widely investigated. This present study assessed compliance with guidelines and its effect on CDI patient outcomes as compared with before these recommendations. A retrospective study included all adult inpatients with an initial episode of CDI treated in a single academic center from January 2009 to August 2014. Patients after guideline publication were compared with patients treated in 2009-2010. Demographic, clinical, and laboratory data were collected to stratify for disease severity. Outcome measures included compliance with guidelines, mortality, length of stay (LOS), and surgical intervention for CDI. A total of 1021 patients with CDI were included. Based upon the 2010 guidelines, 42 (28.8%) of 146 patients treated in 2009 would have been considered undertreated, and treatment progressively improved over time, as inadequate treatment decreased to 10.0% (15/148 patients) in 2014 (P = 0.0005). Overall, patient outcomes with guideline-adherent treatment decreased CDI attributable mortality twofold (P = 0.006) and CDI-related LOS by 1.9 days (P = 0.0009) when compared with undertreated patients. Compliance with IDSA/SHEA guidelines was associated with a decreased risk of mortality and LOS in hospitalized patients with CDI.

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