Moxifloxacin therapy as a risk factor for Clostridium difficile-associated disease during an outbreak: attempts to control a new epidemic strain.
An outbreak of Clostridium difficile-associated disease (CDAD) caused by the epidemic North American pulsed-field gel electrophoresis type 1 (NAP1) strain began after a formulary change from levofloxacin to moxifloxacin. Cases of CDAD were associated with moxifloxacin use, but a formulary change back to levofloxacin failed to reduce rates of disease. Substituting use of one fluoroquinolone with use of another without also controlling the overall use of drugs from this class is unlikely to control outbreaks caused by the NAP1 strain of C. difficile.
Biller
Priscilla
P
Holy Spirit Hospital, Camp Hill, PA, USA.
Shank
Beth
B
Lind
Leah
L
Brennan
Meghan
M
Tkatch
Lisa
L
Killgore
George
G
Thompson
Angela
A
McDonald
L Clifford
LC
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000009:adverse effects*; D001372:Aza Compounds / Q000009:adverse effects*; D016360:Clostridioides difficile / Q000187:drug effects; D003428:Cross Infection / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D005260:Female; D024841:Fluoroquinolones; D006801:Humans; D064704:Levofloxacin; D008297:Male; D000077266:Moxifloxacin; D015242:Ofloxacin / Q000627:therapeutic use; D011804:Quinolines / Q000009:adverse effects*; D012307:Risk Factors
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D064704:Levofloxacin; D015242:Ofloxacin; D000077266:Moxifloxacin