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790. Evaluation of Connecticut Medical Providers Concordance with 2017 IDSA/SHEA Clostridioides difficile Treatment Guidelines in New Haven County, 2017-2019
BACKGROUND: Treatment guidelines for Clostridioides difficile infection (CDI) were updated by the Infectious Disease Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) in 2017, notably for disease severity and antibiotic recommendations. Our objectives were to as...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777245/ http://dx.doi.org/10.1093/ofid/ofaa439.980 |
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author | Luc, Casey M Olson, Danyel M Banach, David Hadler, James Clogher, Paula |
author_facet | Luc, Casey M Olson, Danyel M Banach, David Hadler, James Clogher, Paula |
author_sort | Luc, Casey M |
collection | PubMed |
description | BACKGROUND: Treatment guidelines for Clostridioides difficile infection (CDI) were updated by the Infectious Disease Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) in 2017, notably for disease severity and antibiotic recommendations. Our objectives were to assess Connecticut medical providers’ concordance (2017-2019) with the 2017 update. The effect of guideline concordance on the risk of CDI recurrence was also assessed. METHODS: Using data from the Connecticut Emerging Infections Program’s CDI surveillance in New Haven County, severity and concordance were defined. For severity, white blood cell count and presence of megacolon and/or ileus were used. Concordant treatment was defined as receiving the recommended first-line antibiotic (vancomycin for adult patients, vancomycin or metronidazole for pediatric patients) for exactly 10 days. In univariate & multivariate analyses, significance was determined by a p-value of < 0.05. RESULTS: Of 1,216 cases, concordance increased from 10.0% in 2017 to 36.9% in 2019. Concordance with first-line antibiotic increased from 40.2% in 2017 to 80.8% in 2019. Concordance was highest for fulminant cases (62.2%). The recurrence rate was 11.2% and highest for non-severe cases and older cases but was not significantly associated with concordance. Concordance with selected treatment criteria by year, 2017-2019 [Image: see text] CONCLUSION: From 2017 through 2019, CDI treatment in New Haven County increasingly was concordant with the updated 2017 IDSA/SHEA guidelines, but still low overall in 2019. Although concordance with treatment did not affect recurrence risk, close attention should be paid by medical providers to non-severe cases and older cases as they are at an increased risk for recurrence. DISCLOSURES: All Authors: No reported disclosures |
format | Online Article Text |
id | pubmed-7777245 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-77772452021-01-07 790. Evaluation of Connecticut Medical Providers Concordance with 2017 IDSA/SHEA Clostridioides difficile Treatment Guidelines in New Haven County, 2017-2019 Luc, Casey M Olson, Danyel M Banach, David Hadler, James Clogher, Paula Open Forum Infect Dis Poster Abstracts BACKGROUND: Treatment guidelines for Clostridioides difficile infection (CDI) were updated by the Infectious Disease Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) in 2017, notably for disease severity and antibiotic recommendations. Our objectives were to assess Connecticut medical providers’ concordance (2017-2019) with the 2017 update. The effect of guideline concordance on the risk of CDI recurrence was also assessed. METHODS: Using data from the Connecticut Emerging Infections Program’s CDI surveillance in New Haven County, severity and concordance were defined. For severity, white blood cell count and presence of megacolon and/or ileus were used. Concordant treatment was defined as receiving the recommended first-line antibiotic (vancomycin for adult patients, vancomycin or metronidazole for pediatric patients) for exactly 10 days. In univariate & multivariate analyses, significance was determined by a p-value of < 0.05. RESULTS: Of 1,216 cases, concordance increased from 10.0% in 2017 to 36.9% in 2019. Concordance with first-line antibiotic increased from 40.2% in 2017 to 80.8% in 2019. Concordance was highest for fulminant cases (62.2%). The recurrence rate was 11.2% and highest for non-severe cases and older cases but was not significantly associated with concordance. Concordance with selected treatment criteria by year, 2017-2019 [Image: see text] CONCLUSION: From 2017 through 2019, CDI treatment in New Haven County increasingly was concordant with the updated 2017 IDSA/SHEA guidelines, but still low overall in 2019. Although concordance with treatment did not affect recurrence risk, close attention should be paid by medical providers to non-severe cases and older cases as they are at an increased risk for recurrence. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2020-12-31 /pmc/articles/PMC7777245/ http://dx.doi.org/10.1093/ofid/ofaa439.980 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Poster Abstracts Luc, Casey M Olson, Danyel M Banach, David Hadler, James Clogher, Paula 790. Evaluation of Connecticut Medical Providers Concordance with 2017 IDSA/SHEA Clostridioides difficile Treatment Guidelines in New Haven County, 2017-2019 |
title | 790. Evaluation of Connecticut Medical Providers Concordance with 2017 IDSA/SHEA Clostridioides difficile Treatment Guidelines in New Haven County, 2017-2019 |
title_full | 790. Evaluation of Connecticut Medical Providers Concordance with 2017 IDSA/SHEA Clostridioides difficile Treatment Guidelines in New Haven County, 2017-2019 |
title_fullStr | 790. Evaluation of Connecticut Medical Providers Concordance with 2017 IDSA/SHEA Clostridioides difficile Treatment Guidelines in New Haven County, 2017-2019 |
title_full_unstemmed | 790. Evaluation of Connecticut Medical Providers Concordance with 2017 IDSA/SHEA Clostridioides difficile Treatment Guidelines in New Haven County, 2017-2019 |
title_short | 790. Evaluation of Connecticut Medical Providers Concordance with 2017 IDSA/SHEA Clostridioides difficile Treatment Guidelines in New Haven County, 2017-2019 |
title_sort | 790. evaluation of connecticut medical providers concordance with 2017 idsa/shea clostridioides difficile treatment guidelines in new haven county, 2017-2019 |
topic | Poster Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777245/ http://dx.doi.org/10.1093/ofid/ofaa439.980 |
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