Abstract
Introduction:
Clostridioides difficile infection (CDI) is associated with high morbidity and mortality rates, particularly linked to antibiotic use. Given that most antibiotics are prescribed in outpatient care, reducing antibiotic use in this sector is crucial.
Research Objectives:
This study aims to determine the burden of CDI and its association with short- and long-term antibiotic use. Additionally, we aim to identify common antibiotics used to treat CDI and hospital-level predictors for antibiotic use. A standardized method for global outpatient antimicrobial use collection will also be developed.
Methods:
The study has analysed data from a Swedish population cohort to assess CDI-associated mortality and its correlation with antibiotic use within 30 and 180 days prior to the episode. Global-PPS data will be utilised to identify frequently used antibiotics for CDI treatment and has been utilised to explore hospital-level predictors. The outpatient module of the Global-PPS will be implemented and evaluated across various outpatient settings, including emergency wards.
(Expected) Outcomes: The research determined high CDI-associated morbidity and mortality, even among younger populations, and found an association with 30-day and 180-day prior antibiotic use. We additionally found important hospital-level predictors from the Global-PPS database, such as case mix and number of beds. A first evaluation of the outpatient Global-PPS module revealed high satisfaction among participants.
The ongoing research is expected to reveal heterogeneous prescribing patterns for the treatment of CDI across different regions, and to explore the feasibility of the outpatient module of the Global-PPS among emergency wards in several countries.
Significance/Impact:
This research will highlight the critical need to reduce antibiotic use, particularly in outpatient care, to mitigate the incidence of CDI. The findings will support the implementation of the Global-PPS outpatient module as a standardized method for antibiotic stewardship, ultimately contributing to better healthcare outcomes.
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