{"id":60,"date":"2008-09-18T09:18:13","date_gmt":"2008-09-18T14:18:13","guid":{"rendered":"http:\/\/blogs.nejm.org\/pov\/hiv-id-observations\/?p=60"},"modified":"2008-09-18T09:18:13","modified_gmt":"2008-09-18T14:18:13","slug":"c-diff-the-cure-for-antibiotic-abuse","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/c-diff-the-cure-for-antibiotic-abuse\/2008\/09\/18\/","title":{"rendered":"C. diff: The cure for antibiotic abuse"},"content":{"rendered":"

Even with market doom-and-gloom dominating the news, there’s a good article in yesterday’s Wall Street Journal <\/a>on Clostridium difficile <\/em>(C. diff).\u00a0 It gives an accurate summary (in lay language) of the problem, several pertinent clinical anecdotes,\u00a0and quotations from national experts.<\/p>\n

But this part in particular caught my eye:<\/p>\n

She says that among other measures, the hospital has cut its post-operative antibiotic doses for all joint-replacement surgeries to two from three to avoid C. diff infections.<\/p><\/blockquote>\n

No offense intended, but anytime “routine” antibiotic use is reduced on surgical patients,\u00a0it’s notable.\u00a0 Practically reportable.\u00a0 (One might question <\/a>why any post-operative antibiotic doses\u00a0are given at all<\/em> — but we’ll take this small victory anyway.)<\/p>\n

Human beings\u00a0love<\/em> antibiotics — all of us are guilty of this love affair, health care providers and patients alike.\u00a0 (This is a\u00a0great cartoon!<\/a>)\u00a0 My first introduction to this phenomenon was during\u00a0a medicine rotation in medical school, when the esteemed senior physician on rounds obviously\u00a0had a bad cold.\u00a0 After a particularly noisy\u00a0bout of sneezing (and what was he doing in the hospital, one might wonder), he confessed that the cold he could deal with —\u00a0but the nausea from the erythromycin he’d\u00a0prescribed for\u00a0himself “just in case” was driving him crazy.<\/p>\n

But this new “hypervirulent” C. diff has changed the equation, in a way that warnings about antibiotic side effects<\/a> and risk of resistance never could.\u00a0 One of my friends, a maxillofacial surgeon,\u00a0thinks\u00a0long and hard\u00a0about every antibiotic prescription ever since one of his patients had severe C diff — requiring a colectomy and prolonged ICU stay — after a brief outpatient course of clindamycin.<\/p>\n

And those unfortunate patients who have had C diff have\u00a0been thoroughly\u00a0cured of any “just in case” mentality towards\u00a0antibiotics for sniffles, colds, sore throats, minor sinus issues, and coughs.\u00a0 Alas, a case of C diff is more effective than “Your cold is caused by a virus; antibiotics don’t work for viruses,” which oddly has little traction at all.<\/p>\n","protected":false},"excerpt":{"rendered":"

Even with market doom-and-gloom dominating the news, there’s a good article in yesterday’s Wall Street Journal on Clostridium difficile (C. diff).\u00a0 It gives an accurate summary (in lay language) of the problem, several pertinent clinical anecdotes,\u00a0and quotations from national experts. But this part in particular caught my eye: She says that among other measures, the […]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,5,8],"tags":[72,131,203],"class_list":["post-60","post","type-post","status-publish","format-standard","hentry","category-health-care","category-infectious-diseases","category-patient-care","tag-antibiotics","tag-c-diff","tag-clostridium-difficile"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/60","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=60"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/60\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=60"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=60"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=60"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}