Nasia Safdar, MD, PhD, professor, Infectious Disease and vice chair for research, has been awarded nearly $2.5M over 5 years from the National Institutes of Health - Agency for Healthcare Research and Quality (R01 award) for a proposal entitled, "Fluoroquinolone Restriction for the Prevention of C. difficile Infection (CDI): the FIRST Trial."

Clostridium difficile infection (CDI), often referred to as C diff, occurs when the bacterium C. difficile infects the gut. Symptoms can include debilitating, severe diarrhea and life-threatening inflammation of the colon. C. difficile bacteria are commonly found in the environment. Some people naturally carry the microbes in their gut without having suffering from any ill effects, but CDI can be hazardous - especially for high-risk individuals such as people who are have weakened immune systems due to underlying medical issues or advanced age.

Taking antibiotics raises the risk of CDI, because antibiotics can disrupt the normal balance of gut bacterial species. Some classes of antibiotics in particular, including fluoroquinolones (which are sometimes used for serious bacterial infections such as certain types of bacterial pneumonia), are highly associated with CDI risk.

Because C diff spores are very difficult to kill and are easily transmitted on surfaces and through person-to-person hand contact, CDI can spread throughout health care facilities.

"Each year, Clostridium difficile infection (CDI) affects 453,000 Americans, causes 29,000 deaths, and leads to an estimated $4.8B in excess costs in acute care hospitals within the US," writes Dr. Safdar.

The study is investigating the effectiveness and implementation of a fluoroquinolones pre-prescription authorization approach as an antimicrobial stewardship strategy to target and prevent CDI, promote appropriate antibiotic use, and reduce the transmission of resistant bacteria.

With pre-prescription authorization, a category of antibiotic drug can only be prescribed by a health care provider within a health care system if there is prior approval from an antimicrobial stewardship team, which includes doctors (MD and PharmD) who have expertise in the wise use of antibiotics.

Resources:

• "Dr. Nasia Safdar highlighted by Agency for Healthcare Research and Quality," Department of Medicine, December 20, 2018