A number of factors are known to increase the risk of developing Clostridioides difficile (C diff) infection (CDI); these include certain medications, chronic conditions, and gastrointestinal procedures. However, the major risk factors for CDI are antibiotic use, hospitalization, and advanced age. By recognizing patients’ risk factors for C diff, clinicians can triage appropriate therapies to minimize risk and potentially avoid the infection.
Part of a larger myCME™ initiative on optimizing the management of patients with C diff, this case study centers on best practices for an elderly male resident of a long-term-care facility who has a history of multiple chronic illnesses; the patient was recently seen in the emergency department for evaluation of severe diarrhea. Evidence-based approaches to screening this patient for CDI are reviewed, as are initial approaches to antibiotic therapy. As the judicious use of antibiotics is a key component of preventing initial and recurrent CDI, updated guidance from Infectious Diseases Society of America and Society for Healthcare Epidemiology of America relative to effective antibiotic stewardship are reviewed in detail.