Infection Prevention
IP
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LESS IS MORE
Antibiotic Stewardship Is a Weapon Against C. diff
Here's what you can do to
protect your patients and staff
from Clostridium difficile,
according to Belinda
Ostrowsky, MD, MPH, director
of epidemiology, stewardship
and infection prevention for
the Montefiore Health System
in New York. Here are 4 of her
recommendations:
• Know the symptoms.
Unrecognized C. diff patients
can quickly spread the dis-
ease to other patients in any healthcare facility. When you're
determining whether patients feel well enough for surgery,
ask about diarrhea, the primary symptom of C. diff, as well as
other potential symptoms: abdominal cramping and pain,
fever, nausea, weight loss, and, especially in older patients, a
failure to thrive. The goal should be to recognize it quickly, so
you don't put other patients at risk.
• Not every surgery requires antibiotics. Some clean proce-
dures don't require prophylactic antibiotics. There are guidelines
in infectious disease and surgical literature that go over the types
that do, as well as the types of agents to use, the timing and the
needed duration.
• Choose appropriate antibiotics. In the battle against C. diff,
which is a tangible result of overuse of antibiotics, less is more:
• JUDICIOUS Some surgical procedures don't require antibiotics
before surgery, says Belinda Ostrowsky, MD, MPH.