C. Difficile Prevalence Underscores Pharmacist's Antibiotic Stewardship Role

The US Centers for Disease Control and Prevention today reported that nearly half a million Clostridium difficile infections occurred in a single year, highlighting a critical need for improved antibiotic use.

Approximately two-thirds of the infections were linked to health care facility stays, the CDC stated. Among those infected, 29,000 patients died within 1 month of their initial C. difficile diagnosis, and 15,000 of those deaths were directly attributed to the infection.

“C. difficile infections cause immense suffering and death for thousands of Americans each year,” CDC Director Tom Frieden, MD, MPH, said in a press release. “These infections can be prevented by improving antibiotic prescribing and by improving infection control in the health care system.”

Though staggering, the findings underscore the important role pharmacists play on antibiotic stewardship teams and support the practices pharmacists already undertake.

“I think this serves as a really nice reinforcement of the value the pharmacist provides on a stewardship team,” said Brian Potoski, PharmD, BCPS, associate director of the Antibiotic Management Program at University of Pittsburgh Medical Center, in an exclusive interview with Pharmacy Times. “We have to get out of the thinking that antibiotics are benign.”

Although more than half of all hospitalized patients receive antibiotics during their stay, 30% to 50% of those medications are prescribed unnecessarily or incorrectly, the CDC noted. A 30% decrease in antibiotics linked to C. difficile infections could reduce the deadly infections by more than 25% in hospitalized and recently discharged patients, another recent CDC study found.

Dr. Potoski said the pharmacist’s antibiotic knowledge will be a key weapon in achieving the CDC’s infection reduction and stewardship goals. Although pharmacists may meet resistance from their colleagues, perseverance, patience, and education can help support stewardship goals.

“In some situations, you are not going to suddenly have the light bulb moment that changes someone’s opinion,” Dr. Potoski said, “You are going to have the opportunity to show you are a partner. We want good outcomes in their patients too, but we have a good reason for recommending what we recommend. Use a longitudinal approach…to say this is the data, and here’s why.”

Sharing information and collaboration must underscore any efforts, Dr. Potoski added.

“The silo mentality is not going to work,” Dr. Potoski said. “If we know something, and we are not sharing it, it does not do any good.”