Patients, antibiotics and Clostridioides difficile: when your best friend becomes your worst enemy

Patients with recurrent Clostridioides difficile infection (rCDI) suffer long after infection. However, knowledge is incomplete regarding their perceptions of in-hospital care, antibiotic treatment and the most common risk factors for rCDI. Valid information processes are crucial for enabling such patients to avoid the suboptimal use of healthcare services and gain health literacy, good health and quality of life. This study aims to explore rCDI patients' perceptions of the causes of rCDI, information processes and strategies for the future.

Ten interviews, conducted with rCDI patients based on open-ended questions, were analysed using qualitative content analysis.

All the respondents identified antibiotic treatment as a trigger of rCDI, but they were unaware of other important factors. They also reported receiving inadequate information, often entirely absent or delivered by healthcare professionals under great pressure, together with other barriers that prevented successful information transmission. In addition to a lack of proper information, they described self-created barriers, some of which were severely counterproductive or even harmful, such as avoiding healthcare when they were ill or not collecting prescribed antibiotics due to fear.

The respondents were often left to seek information and develop explanatory models, strategies and behaviours for the future by themselves. We recommend more standardized and personalized patient information to support effective preventive behaviours and to foster a better understanding of one of the most important tools of modern medicine-antibiotics.