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Diagnostic and treatment delays in recurrent Clostridium difficile-associated disease

Danielle Scheurer1

  • 1Brigham and Women's Hospital, Boston, MA 02115, USA. dscheurer@partners.org

Journal of Hospital Medicine
|April 29, 2008
PubMed

Insights

Hospitalists face challenges in diagnosing and treating Clostridium difficile-associated disease (CDAD). While recurrent CDAD patients received earlier treatment, diagnostic delays persist, highlighting opportunities for hospitalist intervention.

Area of Science:

  • Infectious Diseases
  • Hospital Medicine
  • Clinical Outcomes Research

Background:

  • Clostridium difficile-associated disease (CDAD) is a significant concern in inpatient settings.
  • Hospitalists play a crucial role in the prompt management of CDAD.

Purpose of the Study:

  • To evaluate the time to diagnosis and treatment for initial and recurrent CDAD episodes in hospitalized patients.
  • To identify potential areas for improvement in CDAD patient care by hospitalists.

Main Methods:

  • Retrospective cohort study of inpatients diagnosed with CDAD.
  • Analysis of data from Brigham and Women's Hospital between 1997 and 2004.
  • Comparison of time to diagnosis and treatment between initial and recurrent CDAD episodes.

Main Results:

  • Mean time to sampling was comparable for initial and recurrent CDAD (2.09–2.24 days).
  • Mean time to treatment was shorter for recurrent CDAD but still averaged 2.5 days.
  • Patients with recurrent CDAD were treated earlier but not diagnosed earlier than those with initial disease.

Conclusions:

  • Significant delays in both diagnosis and treatment were observed for both initial and recurrent CDAD.
  • Hospitalists have a key opportunity to improve patient care by reducing diagnostic and treatment delays.
  • Earlier treatment in recurrent cases suggests potential for improved management strategies.
Abstract

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