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Thursday, February 2, 2017

Antibiotic restriction, not deep cleaning, appears to have halted C. difficile epidemic.

Antibiotic restriction, not deep cleaning, appears to have halted C. difficile epidemic according to new research.Widespread overuse of fluoroquinolone antibiotics like ciprofloxacin appears to have been the primary driver of the Clostridium difficile epidemic in the U.K., according to new research. Investigators concluded that restriction of fluoroquinolone antibiotics, rather than deep cleaning and other infection control measures, led to significant reductions in the incidence of C. difficile infections. Emergency measures such as ‘deep cleaning’ and careful antibiotic prescribing were introduced and numbers of C. difficile infections gradually fell by 80% but no one was sure precisely why. The study shows that the C. difficile epidemic was an unintended consequence of intensive use of an antibiotic class, fluoroquinolones, and control was achieved by specifically reducing use of this antibiotic class, because only the C. difficile bugs that were resistant to fluoroquinolones went away.” To determine whether it was antibiotic restriction or hospital infection control measures that achieved the significant decline in C. difficile infections (CDIs) after 2006, The study evaluated regional and national data on CDI incidence and antimicrobial prescriptions from 1998 to 2014. They also evaluated whole genome sequences from 4,045 national and international C. difficile isolates to estimate the incidence of CDIs caused by strains resistant or susceptible to fluoroquinolone. They hypothesized that CDIs caused by fluoroquinolone-resistant strains would have declined faster if the outbreak was stopped by antibiotic restriction, and that secondary transmitted infections of both resistant and susceptible strains would decline at the same rate if the outbreak was stopped by infection control measures. First, they determined that prescribing of fluoroquinolone and cephalosporin strongly correlated with CDI incidence compared with overall antibiotic prescribing continue