496. Secondary Prophylaxis for Clostridium difficile infection - A Physician Practice Assessment
Session: Poster Abstract Session: Healthcare Epidemiology: Updates in C. difficile
Thursday, October 4, 2018
Room: S Poster Hall
Posters
  • C diff secondary prophylaxis IDweek.pdf (1.0 MB)
  • Background:

    Recurrent Clostridium difficile infection (CDI) is associated with significant morbidity, mortality and health care related costs. Up to 30% of CDI cases recur, resulting in 83,000 cases of recurrent CDI per year. Although agents for primary and secondary prophylaxis for CDI including the use of probiotics, antibiotics, fecal microbiota transplantations, and newer therapies such as bezlotoxumab have been reported, there is no consensus guidelines regarding their use. The purpose of this study is to assess physician practices regarding secondary prophylaxis for CDI.

    Methods:

    This cross-sectional study using Qualtrics electronic survey (24 questions) assessed physician practice preferences. The survey was distributed through institutional emails and through the Infectious Disease Society of America “IDea Exchange” forum. Responses were collected and analyzed using descriptive statistics.

    Results:

    A total of 246 surveys were completed. Physicians were surveyed from greater than 100 locations (see Figure 1). Most (229, 93%) of the physicians practiced in an inpatient setting. Respondent specialties were primarily infectious diseases (138, 56%) followed by internal medicine (72, 29%). Most physicians (173, 71%) use secondary prophylaxis for CDI prevention (see Figure 2). Vancomycin (121, 70%) and probiotics (114, 66%) were most commonly used for CDI secondary prophylaxis, (see Figure 3). Of 164 physicians who used secondary prophylaxis half of them (89, 54.2%), used prophylaxis only for patients with a history of recurrent CDI receiving antibiotics and about a third, (49, 29.9%) utilized it for patients with a history of CDI who were receiving antibiotics. ID physicians were more likely to prescribe secondary prophylaxis as compared to non-ID physicians (85% of 127 respondents vs. 75% of 85 respondents, p=0.052). Use of secondary prophylaxis was similar among private practice and academic physicians (84% of 39 vs. 80% of 157 respondents, p = 0.591).

    Conclusion:

    The majority of the physicians who responded to this survey use secondary prophylaxis to prevent recurrent CDI, hence future CDI guidelines need to address the role of secondary prophylaxis in clinical practice.

    Mindy Sampson, DO, Infectious Diseases and International Medicine, University of South Florida, Tampa, FL, Kristen Zeitler, PharmD, Department of Pharmacy, Tampa General Hospital, Tampa, FL, Jasmine R Marcelin, MD, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, Sadaf Aslam, MD, Division of Infectious Diseases and International Medicine, University of South Florida, Morsani College of Medicine, Tampa, FL, John Sinnott, MD, FACP, FIDSA, FSHEA, Internal Medicine, University of South Florida, Tampa, FL and Seetha Lakshmi, MD, Division of Infectious Diseases and International Medicine, University of South Florida, Tampa, FL

    Disclosures:

    M. Sampson, None

    K. Zeitler, None

    J. R. Marcelin, None

    S. Aslam, None

    J. Sinnott, None

    S. Lakshmi, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.