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Updated: Feb 10, 2026
A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
Published on: May 25, 2017
Evaluation of a best practice alert to reduce unnecessary Clostridium difficile testing following receipt of a
Anastasia Bilinskaya1, Kellie J Goodlet2, Michael D Nailor3
1University of Connecticut School of Pharmacy, 69 North Eagleville Road, Storrs, CT 06269, USA.
Introduction:
This study examined the effect of an alert notifying providers ordering Clostridium difficile PCR when their patient received a laxative within 24 hours at four hospitals.
Methods:
All patients whose provider received the laxative alert when ordering C. difficile testing were examined.
Results:
Three hundred sixty-six patients had 483 alerts triggered, with 75% overridden. While 74% of patients had ≥2 bowel movements immediately pre-order, 33% of C. difficile tests were not performed due to no stool production post-order or laboratory rejection of formed stool. Of those with completed tests, 49% had ≤1 cardinal sign of C. difficile infection (CDI) and only 18% tested positive by PCR. There were no differences in frequency of CDI signs between the PCR-positive and PCR-negative patients.
Conclusions:
C. difficile testing was common among patients receiving laxatives. Patients testing positive for C. difficile looked clinically similar to patients testing negative, suggesting a high false-positive rate.
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