Management and characteristics of patients suffering from Clostridiodes difficile infection in primary care

Background Clostridioides difficile infection (CDI) is rising and increases patient healthcare costs due to extended hospitalisation, tests and medications. Management of CDI in French primary care is poorly reported. Objectives To characterise patients suffering from CDI, managed in primary care an...

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Autores principales:	Maria Klezovich-Bénard, Frédérique Bouchand, Elisabeth Rouveix, Pierre L. Goossens, Benjamin Davido
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2021
Materias:	c. difficile primary care general practitioner infection management Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/e7585334475047378fe85f58d679102e
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spelling	oai:doaj.org-article:e7585334475047378fe85f58d679102e2021-11-11T14:23:41ZManagement and characteristics of patients suffering from Clostridiodes difficile infection in primary care1381-47881751-140210.1080/13814788.2021.1998447https://doaj.org/article/e7585334475047378fe85f58d679102e2021-01-01T00:00:00Zhttp://dx.doi.org/10.1080/13814788.2021.1998447https://doaj.org/toc/1381-4788https://doaj.org/toc/1751-1402Background Clostridioides difficile infection (CDI) is rising and increases patient healthcare costs due to extended hospitalisation, tests and medications. Management of CDI in French primary care is poorly reported. Objectives To characterise patients suffering from CDI, managed in primary care and describe their clinical outcomes. Methods Retrospective observational study based on survey data among 500 randomly selected General Practitioners (GPs) surveyed in France from September 2018 to April 2019. GPs were asked to complete a multiple-choice questionnaire for each reported patient presenting a CDI. Responses were analysed according to clinical characteristics. Treatment strategies were compared according to the outcome: recovery or recurrent infection. Results Participation rate was 8.6% (n = 43/500) with two incomplete questionnaires. Data from 41 patients with an actual diagnosis of CDI were analysed. Recovery was observed in 61% of patients with a confirmed diagnosis of CDI. In the recovery group, this was exclusively a primary episode, most patients (72%) had no comorbidities, were significantly younger (p = 0.02) than the ones who relapsed and 92% were successfully treated with oral metronidazole. Duration of diarrhoea after antimicrobial treatment initiation was significantly shorter in the recovery group (≤ 48 h) (p = 0.03). Cooperation with hospital specialists was reported in 28% of the recovery group versus 87.5% of the recurrent group (p = 0.0003). Overall, GPs managed successfully 82.9% of cases without need of hospital admission. Conclusion GPs provide relevant ambulatory care for mild primary episodes of CDI using oral metronidazole. Persistent diarrhoea despite an appropriate anti-Clostridiodes regimen should be interpreted as an early predictor of relapse.Maria Klezovich-BénardFrédérique BouchandElisabeth RouveixPierre L. GoossensBenjamin DavidoTaylor & Francis Grouparticlec. difficileprimary caregeneral practitionerinfectionmanagementMedicine (General)R5-920ENEuropean Journal of General Practice, Vol 27, Iss 1, Pp 320-325 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	c. difficile primary care general practitioner infection management Medicine (General) R5-920
spellingShingle	c. difficile primary care general practitioner infection management Medicine (General) R5-920 Maria Klezovich-Bénard Frédérique Bouchand Elisabeth Rouveix Pierre L. Goossens Benjamin Davido Management and characteristics of patients suffering from Clostridiodes difficile infection in primary care
description	Background Clostridioides difficile infection (CDI) is rising and increases patient healthcare costs due to extended hospitalisation, tests and medications. Management of CDI in French primary care is poorly reported. Objectives To characterise patients suffering from CDI, managed in primary care and describe their clinical outcomes. Methods Retrospective observational study based on survey data among 500 randomly selected General Practitioners (GPs) surveyed in France from September 2018 to April 2019. GPs were asked to complete a multiple-choice questionnaire for each reported patient presenting a CDI. Responses were analysed according to clinical characteristics. Treatment strategies were compared according to the outcome: recovery or recurrent infection. Results Participation rate was 8.6% (n = 43/500) with two incomplete questionnaires. Data from 41 patients with an actual diagnosis of CDI were analysed. Recovery was observed in 61% of patients with a confirmed diagnosis of CDI. In the recovery group, this was exclusively a primary episode, most patients (72%) had no comorbidities, were significantly younger (p = 0.02) than the ones who relapsed and 92% were successfully treated with oral metronidazole. Duration of diarrhoea after antimicrobial treatment initiation was significantly shorter in the recovery group (≤ 48 h) (p = 0.03). Cooperation with hospital specialists was reported in 28% of the recovery group versus 87.5% of the recurrent group (p = 0.0003). Overall, GPs managed successfully 82.9% of cases without need of hospital admission. Conclusion GPs provide relevant ambulatory care for mild primary episodes of CDI using oral metronidazole. Persistent diarrhoea despite an appropriate anti-Clostridiodes regimen should be interpreted as an early predictor of relapse.
format	article
author	Maria Klezovich-Bénard Frédérique Bouchand Elisabeth Rouveix Pierre L. Goossens Benjamin Davido
author_facet	Maria Klezovich-Bénard Frédérique Bouchand Elisabeth Rouveix Pierre L. Goossens Benjamin Davido
author_sort	Maria Klezovich-Bénard
title	Management and characteristics of patients suffering from Clostridiodes difficile infection in primary care
title_short	Management and characteristics of patients suffering from Clostridiodes difficile infection in primary care
title_full	Management and characteristics of patients suffering from Clostridiodes difficile infection in primary care
title_fullStr	Management and characteristics of patients suffering from Clostridiodes difficile infection in primary care
title_full_unstemmed	Management and characteristics of patients suffering from Clostridiodes difficile infection in primary care
title_sort	management and characteristics of patients suffering from clostridiodes difficile infection in primary care
publisher	Taylor & Francis Group
publishDate	2021
url	https://doaj.org/article/e7585334475047378fe85f58d679102e
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Management and characteristics of patients suffering from Clostridiodes difficile infection in primary care

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