Clinician Management Preferences for Clostridioides difficile Infection in Adults: A 2024 Emerging Infections Network...

Area of Science:

• Infectious Diseases
• Microbiome Therapeutics
• Clinical Practice Guidelines

Background:

• The 2021 Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) guidelines updated Clostridioides difficile infection (CDI) management.
• New microbiome-based therapies for recurrent CDI have emerged since the guidelines were published.

Purpose of the Study:

• To survey infectious diseases (ID) clinicians regarding their experiences, practices, and challenges in managing CDI.
• To understand current treatment preferences and barriers to accessing and prescribing CDI therapies.

Main Methods:

• An electronic survey was distributed to IDSA Emerging Infections Network members in May 2024.
• The survey targeted US-based ID physicians managing adult CDI, assessing treatment preferences, clinical practices, and barriers.

Main Results:

• Vancomycin remains the most prescribed agent for initial, nonfulminant CDI (83%).
• Barriers to fidaxomicin use include insurance coverage challenges (82%); bezlotoxumab is available but not routinely used by 33%.
• Fecal microbiota transplantation (FMT) is recommended by 87% but accessible to only 48% of clinicians.

Conclusions:

• High costs, insurance challenges, and limited availability of CDI therapies significantly impact clinical decision-making.
• These barriers hinder adherence to current guideline recommendations for CDI management.