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Infectious diseases

Recent C. difficile reduction in England mostly results from antibiotic stewardship

Restricting the prescribing of fluoroquinolone seems to explain the reduced rates of C. difficile infections in England over the past decade, national study shows.

Petri dish with clostridium difficile culture

Source: CDC/Melissa Dankel

The decrease in Clostridium difficile infections in England over the past ten years has coincided with the introduction of policies advocating improved infection control and restricted antibiotic use

The rate of Clostridium difficile infections in England has decreased by around 80% over 10 years since the introduction of policies advocating improved infection control and restricted antibiotic use. However, it is unknown which of these interventions contributes the most to C. difficile control.

To investigate, researchers combined regional and national data on C. difficile incidence and antimicrobial prescribing data over a 16-year period with genome sequence data from C. difficile isolates.

The team found that the observed decline in C. difficile rates in England was almost entirely due to the disappearance of fluoroquinolone-resistant isolates, while the transmission of non-resistant strains remained unchanged or even increased.

Writing in The Lancet Infectious Diseases[1]( online, 24 January 2017), the team say the results show that restricting fluoroquinolone use should be central to any C. difficile control programme, particularly when fluoroquinolone-resistant strains are prevalent.

Citation: Clinical Pharmacist DOI: 10.1211/CP.2017.20202390

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Supplementary images

  • Petri dish with clostridium difficile culture

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