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C diff recurrences 'pose biggest challenge'

Recurrent Clostridium difficile cases (CDIs) are now considered by most doctors to be the biggest challenge when treating the infection, a survey suggests.

The Think C-differently report, published this month, suggests that 50% of UK doctors feel that this issue is currently the most challenging they face.

Around 25,000 cases of CDIs are reported on an annual basis, with the condition costing the NHS around £250m each year.

The 101 health specialists who were polled as part of the report indicate that recurrent CDIs have a heavy financial burden. It is believed that the NHS has to spend up to £10,000 on every case of CDI which is reported.

Graziella Kontkowski, founder of the C-diff Support patient organisation, said greater awareness was required among patients about the risks of CDI recurrences.

She added: “As statistics are now showing that C.difficile is as prevalent in the community setting as it is in the hospital setting, it is essential that doctors working in this area are able to diagnose and treat their patients promptly to ensure recovery is made without complications arising.”

Professor Mark Wilcox, professor of Medical Microbiology, University of Leeds and Leeds Teaching Hospitals, added: “We have come a long way since the very high rates of CDI in 2007-08, but there is still room for continued improvement.

“We must avoid complacency and ensure CDI is appropriately contained by optimising diagnosis, improving treatment and ensuring that systems for reporting CDI are as accurate as possible.”

Readers' comments (3)

  • Andrew Kingsley

    Much has been done over the last few years in hospitals and rates of this infection have been brought down, though there remains more to do.

    Sadly many GPs are not interested in C difficile in the community and will not engage with root cause analysis investigations by public health and infection control teams. This means more people will be doomed to suffer and some may die before lessons are learned - this is not acceptable, many of these infections are avoidable.

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  • Whilst I agree there remains a need for further improvement in prescribing habits in both primary and secondary care environments, this is only one part of the problem. There is a need for improving national awareness of the harms that can be done through antibiotic abuse. Joe Public needs to realise that manipulating prescribers (mis- reporting symptoms, etc) in order to achieve the golden ticket (a prescription) isn't such a grand idea. I have also found self-medicators ('bring a bottle of cipro back from your hols for me, son'), hoarders ('I never take more than a couple of days so I've always got some in hand for next time') and borrowers ('they were in my wife's 'rescue kit' as she has COPD...'). Perhaps it is time for a new national campaign focussing on the antibiotic harms? Although that might spoil the press' favourite occupation of NHS bashing.
    One other point though- who will be doing the RCAs when the PCTs disappear? Community IPNs like me face a very uncertain future at present.

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  • I am a patient that had cdiff caused by antibiotics. My symptoms started in Aug 13 and I was admitted to hospital. Between Aug and Jan I had 2 further episodes of cdiff which were treated at home. The care I received for this infection was inadequate and I had to fight for the correct treatment from the day I left hospital. I was discharged with no information on cdiff. Hospital staff would enter my quarantined room without protection.

    I had to beg for the vancomycin tapering dose on my 3rd occurrence even though the guidelines suggested I should have a more expensive treatment. Finally in January my symptoms stopped. It is now the end of March and my food intake consists of bread, potatoes and soup. Any other foods upset my stomach and causes pain and nausea. I am taking buscopan and brewers yeast and if i try and eat someing new i have to take tramodol for pain yet my symptoms continue and I continue to collapse at work. I have returned to the doctors and keep being told that it will take time and it's a case of trial and error.

    I have asked to see a gastro expert but cannot get referred.

    I feel that both my husband and myself know more about cdiff than any doctor in my area. In fact my sister who worKs as Nurse in America and a doctor who she works with have been more helpful than doctors in the uk.

    Graziella was fantastic, she helped fight my case and put me in touch with the prevention control department who promised to ring me back. Needless to say she didn't.

    I asked for help again today and was told i needed omiprozel a medicine that cdiff sufferers shouldnt take. Again a doctors who has never treated cdiff.

    I would like to know what damage has been done to my stomach amd bowel by cdiff and what damage is still being done through lack of nutrients.

    I would also like doctors to learn how to treat cdiff.

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