Age and Ageing, Vol 28, 578-580, Copyright © 1999 by British Geriatrics Society
H Ludlam, N Brown, O Sule, C Redpath, N Coni and G Owen
BACKGROUND: antibiotic-associated diarrhoea caused by Clostridium difficile
is increasing in hospitals, and older people are at particular risk.
OBJECTIVE: to establish whether reducing patient exposure to injectable
third-generation cephalosporins by substituting alternative antibiotics can
produce a cost-effective reduction in the incidence of
antibiotic-associated diarrhoea. DESIGN: we prospectively investigated 2157
patients admitted to the department of elderly medicine in the year before
introduction of antibiotic restrictions and 2037 patients admitted in the
following year. Patients admitted to other wards, where antibiotic
prescribing was unchanged, acted as controls. SETTING: a 900-bed teaching
hospital in Cambridge, UK. MEASUREMENTS: use and cost of injectable
antibiotics prescribed in the department of elderly medicine and the other
wards studied; occurrence of C. difficile-associated diarrhoea. RESULTS: in
the wards for older people, consumption of injectable cephalosporins fell
by 92% (compared with 8% on other wards) and cases of C.
difficile-associated diarrhoea fell from 98 to 45 (cases in other wards
rose from 213 to 253; P < 0.001). The Pound Sterling 8062 increase in
injectable antibiotic costs on the elderly wards were offset by the release
of 1087 wasted bed-days attributable to the 53 fewer cases, with potential
savings of Pound Sterling 212,000. CONCLUSIONS: restricting the consumption
of injectable third-generation cephalosporins is a cost-effective method of
reducing the incidence of C. difficile-associated diarrhoea.
ARTICLES
An antibiotic policy associated with reduced risk of Clostridium difficile-associated diarrhoea
Microbiology and Public Health Laboratory, Addenbrooke's Hospital, Cambridge, UK. hugo.ludlam@msexc.addenbrookes.anglox.nhs.uk
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  W S Lim, S V Baudouin, R C George, A T Hill, C Jamieson, I Le Jeune, J T Macfarlane, R C Read, H J Roberts, M L Levy, et al. BTS guidelines for the management of community acquired pneumonia in adults: update 2009 Thorax, October 1, 2009; 64(Suppl_3): iii1 - iii55. [Full Text] [PDF]
|
|
|
|
 |
|
 T. Gouliouris, D. R. Forsyth, and N. M. Brown Clostridium difficile-associated diarrhoea (CDAD): new and contentious issues Age Ageing, September 1, 2009; 38(5): 497 - 500. [Full Text] [PDF]
|
|
|
|
 |
|
 T Monaghan, T Boswell, and Y R Mahida Recent advances in Clostridium difficile-associated disease Postgrad. Med. J., March 1, 2009; 85(1001): 152 - 162. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T Monaghan, T Boswell, and Y R Mahida Recent advances in Clostridium difficile-associated disease Gut, June 1, 2008; 57(6): 850 - 860. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Thompson Clostridium difficile-associated disease: update and focus on non-antibiotic strategies Age Ageing, January 1, 2008; 37(1): 14 - 18. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. J. Asha, D. Tompkins, and M. H. Wilcox Comparative Analysis of Prevalence, Risk Factors, and Molecular Epidemiology of Antibiotic-Associated Diarrhea Due to Clostridium difficile, Clostridium perfringens, and Staphylococcus aureus. J. Clin. Microbiol., August 1, 2006; 44(8): 2785 - 2791. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. V McFarland Alternative treatments for Clostridium difficile disease: what really works? J. Med. Microbiol., February 1, 2005; 54(2): 101 - 111. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K.A. O'Connor, M. Kingston, M. O'Donovan, B. Cryan, C. Twomey, and D. O'Mahony Antibiotic prescribing policy and Clostridium difficile diarrhoea QJM, July 1, 2004; 97(7): 423 - 429. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.B. Frenz and A.S. McIntyre Reducing delays in the diagnosis and treatment of Clostridium difficile diarrhoea QJM, August 1, 2003; 96(8): 579 - 582. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
BTS Guidelines for the Management of Community Acquired Pneumonia in Adults Thorax, December 1, 2001; 56(90004): iv1 - 64. [Full Text] [PDF]
|
|
|
|
|
|
L. Davies, J. Hadcroft, K. Mutton, J.E. Earis, and N. Kennedy Antimicrobial management of acute exacerbation of chronic airflow limitation QJM, July 1, 2001; 94(7): 373 - 378. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M H WILCOX Respiratory antibiotic use and Clostridium difficile infection: is it the drugs or is it the doctors? Thorax, August 1, 2000; 55(8): 633 - 634. [Full Text]
|
|