Diagnostic and treatment delays in recurrent Clostridium difficile-associated disease.
BACKGROUND
Because Clostridium difficile-associated disease (CDAD) is primarily an inpatient issue, hospitalists are at the forefront of the timely diagnosis and treatment of patients with this disease.


METHODS
The study was a retrospective cohort of all inpatients with CDAD at Brigham and Women's Hospital from 1997 to 2004 in order to determine the time to diagnosis and treatment in initial and recurrent episodes of disease.


RESULTS
The mean time to sampling, between 2.09 and 2.24 days, was not significantly different between initial and recurrent CDAD hospital episodes. The mean time to treatment (from symptoms and sampling) was shorter in recurrent episodes but was still 2.5 days.


CONCLUSIONS
Patients with recurrent disease were more likely to be treated earlier but not diagnosed earlier than those with initial disease. Because both groups had significant diagnostic and treatment delays, this is an area in which hospitalists can have a major impact on patient care.
Scheurer
Danielle
D
Brigham and Women's Hospital, Boston, MA 02115, USA. dscheurer@partners.org
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000175:diagnosis* / Q000382:microbiology / Q000517:prevention & control*; D015331:Cohort Studies; D003428:Cross Infection / Q000175:diagnosis* / Q000382:microbiology / Q000517:prevention & control*; D005260:Female; D020445:Hospitalists; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D055502:Secondary Prevention; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D008795:Metronidazole; D014640:Vancomycin