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INFECTION CONTROL & PATIENT SAFETY 35 3 Elements Every C. diff Management Approach Should Include By Shannon Barnet C lostridium difficile infection is a significant concern for healthcare institutions, and it may be difficult to identify the best elements for a management and treatment program, according to a study in the Journal of Clinical Pharmacy and erapeutics. In the study, researchers assessed the effects a CDI management policy with clinical pharmacy, medical microbiology and infection control involvement had on the concordance in prescribing practices to severity assessment and pharmacological treatment algorithm. To assess the efficacy of the policy, the researchers compared 141 CDI episodes in the pre- implementation group with 283 post-implementation episodes. ey found the overall treatment concordance to the CDI treatment algorithm was achieved in 48 of 141 cases (34 percent) pre- implementation compared with 136 of 283 cases (48.1 percent) post-implementation. Additionally, the median time to treatment with vancomycin was reduced from five days to one day and the median length of hospital stay decreased from 30 days to 21 days post-implementation. ere was no difference, however, in 30-day all-cause mortality. Ultimately, the researchers concluded a comprehensive CDI management approach should include: 1. Appropriate stakeholder involvement in the development of clinical pathways 2. Education for healthcare workers 3. Prospective audit with intervention feedback Together, these elements "can ensure patients diagnosed with CDI are optimally managed and prescribed the most appropriate therapy based on CDI disease severity." n CDC: Gonorrhea Becoming More Resistant to One Antibiotic By Max Green C exifime, one of several treatments for the sexually transmitted disease gonorrhea, is becoming less effec- tive against the infection, according to a CDC report. The findings, published Nov. 3 in the Journal of the American Medical Associa- tion, reflect that although resistance fell from 2011 to 2013, it began to rise again last year. Cefixime is generally not the first line of treatment for the STD, and the CDC notes there doesn't seem to be any decrease in effectiveness of the primary drug used to treat gonorrhea. "It is essential to continue monitoring an- timicrobial susceptibility and track patterns of resistance among the antibiotics currently used to treat gonorrhea," Robert Kirkcaldy, MD, an epidemiologist in the CDC's division of STD prevention and lead study author, said in a statement. "Recent increases in cefixime resistance show our work is far from over." The results were taken from a review of more than 51,000 samples across 34 U.S. cities. n