P-192. Evaluating the Association of Unnecessary Antibiotic Use with Hospital-Onset Clostridioides difficile Infection at a New York City Hospital
Abstract
Abstract Background Hospital Onset-Clostridioides difficile infection (HO-CDI) is defined as collection of a positive C. difficile lab result on or after day 4 of a patient’s hospital admission. Reduction of HO-CDI remains a multidisciplinary effort. Prior studies have demonstrated frequent inappropriate antibiotic use among patients with CDI. The objective of this study is to evaluate unnecessary antibiotic use in patients with cases of National Healthcare Safety Network (NHSN)-defined HO-CDI compared to non-CDI controls. Methods This case-control study included inpatient adult patients, from 1/1/23 – 2/28/24. HO-CDI cases were selected from standard institutional review. Non-CDI controls were selected based on hospital admission and negative CDI test sent on or later than day 4 of their admission. Cases and controls were matched 2:1 using patient location and index tests within the same month. Antibiotic use (AU) rate of cefepime, ciprofloxacin, levofloxacin, ceftriaxone, and piperacillin-tazobactam 30 days prior to index test was calculated using NHSN definitions. Primary exposure of interest was inappropriate antibiotic use. Outcomes including hospital length of stay (LOS), all-cause mortality, and subsequent recurrent CDI were recorded. A secondary analysis assessed the relationship between race/ethnicity, inappropriate antibiotic use and HO-CDI. Results Two hundred ninety-six patients were included. AU rate was greater in controls compared to HO-CDI cases (p = 0.01)…
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