Abstract

Purpose Clostridium Difficile Infection (CDI) continues to be a major public health concern in the U.S. Despite effective treatment options, there continues to be an increase in Clostridium Difficile infections, recurrence, and mortality. The purpose of this study was to determine whether a standardized computerized prescriber protocol could improve patient management and outcome as recommended by recent guidelines. Methods A retrospective quasi-experimental study of hospitalized adults, between the age of 18 and 89 years, with C. difficile infection presenting to a 443 bed tertiary care referral county teaching hospital was conducted prior to and after the implementation of a hospital computerized CDI protocol. Mortality and recurrence of C. difficile infection were measured to determine the effectiveness of the protocol. . Results Eighty percent of patients were treated in accordance with guidelines prior to and post hospital protocol implementation. Patients treated according to the hospital protocol had a reduced mortality (4.0%) compared to patients treated according to Infectious Disease Society of America (IDSA) guidelines prior to protocol implementation (7.8%, p = 0.0471) and patients not treated according to the hospital protocol after implementation (11.3%, p = 0.0158). As CDI complexity increased, patients were less likely to be treated in accordance with either the IDSA guidelines or the hospital protocol (p < 0.0001) and had a higher rate of total complications and mortality. Conclusions Our study found that the implementation of a standardized computerized prescriber protocol for the management of Clostridium difficile colitis was associated with a lower mortality.

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