Risk Factors for Recurrent Clostridium difficile Infections and Strategies to Decrease Readmissions in a Community Hospital

摘要

Background: Currently there are no universally accepted approaches for the prevention of recurrent Clostridium difficile infections (CDI) following the initial infection. Several studies have identified common risk factors for the emergence of recurrent CDI. Identifying patients at high risk for recurrent CDI through the assessment of risk factors at initial diagnosis could enable health care providers to optimize available treatment options. A vancomycin hydrochloride-tapered regimen may be an effective treatment option for the prevention of recurrent CDI following the initial infection.Methods: In this single-center, prospective study, we examined the efficacy of orally administered vancomycin-tapered regimens for the prevention of recurrent CDI in high-risk patients. High-risk patients were identified using patient risk factors found in a retrospective chart review. The primary objective was to decrease hospital readmissions for recurrent CDI. The secondary objective was to improve the discharge coordination-of-care process by providing a pharmacy benefits evaluation, which ensured vancomycin affordability and assistance in prescription attainment, and discharge counseling.