Doctors Identify Patients at High Risk of C. difficile

Doctors have developed and validated a clinical prediction rule for recurrent Clostridium difficile (C. difficile) infection that was simple, reliable and accurate, and can be used to identify high-risk patients most likely to benefit from measures to prevent recurrence. Their findings appear in a new study in Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute.

"This rule is valuable in clinical practice as it defines a high-risk population in whom awareness of the risk can facilitate more prompt recognition, diagnosis and treatment of recurrent C. difficile," said Ciaran P. Kelly, MD, of Beth Israel Deaconess Medical Center (BIDMC), Harvard Medical School and lead author of the study. "These patients are also most likely to benefit from interventions to prevent recurrence, such as infection control precautions, prudent use of antibiotics, prolongation of metronidazole or vancomycin therapy, and use of probiotics or other prophylactic measures."

The prevention of recurrent C. difficile is a substantial therapeutic challenge. This disorder has become the leading known cause of hospital-acquired infectious diarrhea in the developed world. Despite advances in knowledge of the pathogenesis of C. difficile, the organism continues to afflict millions of patients every year and is associated with increasing morbidity and death.