Antibiotic Prescribing Impact on Clostridium Difficile Risk in Patients on Protein Pump Inhibitors
Antibiotic prescribing in patients on protein pump inhibitors (PPIs) is associated with an increased risk of Clostridium difficile infection. A review was conducted on high-risk antibiotic prescriptions, revealing instances where patients were prescribed against guidelines, leading to potential complications. To address this, following local prescribing guidelines and documenting reasons for antibiotic choice are suggested actions to improve prescribing practices.
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Presentation Transcript
Review of Antibiotic Prescribing associated with increased risk of Clostridium Difficile prescribed to patients on a protein pump inhibitor
Background Clostridium difficile is a bacterium that can infect the bowel and cause diarrhoea. Most common in people who have been recently treated with antibiotics. Risk increased also if over 65, have conditions such as IBD, cancer, kidney disease Are immuno-compromised On PPIs Have had recent GI surgery
Results 109 patients were identified as being prescribed a high risk antibiotic (cephalo-sporins, Quinolones, clindamycin, macrolides and co- amoxiclav) 33 were also on PPI. 16 patients were prescribed in line with loval prescribing group guidelines, based on hospital advice or as a result of multiple allergies (48%)
Patients prescribed against guidance Clinical Indication No. of patients identified Notes Recurrent UTIs 3 No guidelines Cough or exacerbation COPD 5 Prescribed as first line (not Allergy, not on guideline) Epididymo-orchitis 1 No guidelines Urinary tract infection 1 Unclear why chosen Urinary tract infection failed to respond to nitrofurantoin or trimethoprim 2 Guidelines suggest wait for results of MSU ? How practical? Infected cyst 1 ? Needed incision and drainage? Sinusitis 1 Formulary suggests nasal steroid then amoxicillin or doxycycline Cellulitis 3 Used as first line instead of flucloxacillin.
Suggested Actions Ensure local guidelines followed and keep on shared space for ease of reference Ensure document reason for prescribing antibiotics and reason for choice if not in line with guidelines
