title: Moxifloxacin therapy as a risk factor for Clostridium difficile-associated disease during an outbreak: attempts to control a new epidemic strain.
abstract: 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.
authors.affiliation: Holy Spirit Hospital, Camp Hill, PA, USA.
authors.forename: Priscilla
authors.initials: P
authors.lastname: Biller
authors.forename: Beth
authors.initials: B
authors.lastname: Shank
authors.forename: Leah
authors.initials: L
authors.lastname: Lind
authors.forename: Meghan
authors.initials: M
authors.lastname: Brennan
authors.forename: Lisa
authors.initials: L
authors.lastname: Tkatch
authors.forename: George
authors.initials: G
authors.lastname: Killgore
authors.forename: Angela
authors.initials: A
authors.lastname: Thompson
authors.forename: L Clifford
authors.initials: LC
authors.lastname: McDonald
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D064704:Levofloxacin; D015242:Ofloxacin; D000077266:Moxifloxacin