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Most child C. diff cases arise from outpatient treatment


By Steven Ross Johnson
Posted: March 7, 2014 - 12:45 pm ET
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A majority of cases of a severe diarrheal infection in children were linked to the prescribing of antibiotics for other conditions within outpatient settings, according to a study.

The study, published online this week in the journal Pediatrics, found that 71% of the 944 cases of Clostridium difficile, a bacterial infection that causes severe diarrhea, that occurred between January 2010 and December 2011 in children ages 17 and under were identified to have received antibiotics in a community health setting, such as a doctor's office. By contrast, two-thirds of adult cases of C. difficile occur in an inpatient setting.

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Findings of the study were based on data obtained through a survey of a population of more than 2 million children in counties within 10 states. Among the community-associated cases that were diagnosed with infection, 73% were prescribed antibiotics within 12 weeks of developing their illness. Taking antibiotics is a leading cause for developing C. difficile in children and adults when good bacteria that protects against infection is wiped out by antibiotic treatment. About 250,000 infections occur a year in hospital settings, resulting in 14,000 deaths.

The results of the study reinforce calls from government health officials for health providers to improve how they administer antibiotics out of concerns that many are still prescribing them too often and increasing the possibility for the spread of drug-resistant infections.

A report released this week by the Centers for Disease Control and Prevention called for a 30% reduction in prescription for the kind of antibiotics most likely to cause C. difficile infections, saying doing so could reduce the spread of the disease by 26%.

“Improved antibiotic prescribing is critical to protect the health of our nation's children,” CDC Director Dr. Tom Frieden said in a release. “When antibiotics are prescribed incorrectly, our children are needlessly put at risk for health problems, including C. difficile infection and dangerous antibiotic resistant infections.”

Improving antibiotic prescribing practices has been made a priority within President Barack Obama's proposed fiscal 2015 budget released Tuesday. It requests funding for a CDC-led initiative that looks to reduce outpatient prescribing by 20%, reducing C. difficile infections by half in five years.

Follow Steven Ross Johnson on Twitter: @MHsjohnson


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