Most C difficile in kids linked to antibiotics

Most of all pediatric Clostridium difficile infections are the result of a recent course of antibiotics prescribed in a doctor's office for some other condition, according to a new study by the Centers for Disease Control and Prevention (CDC).

The study found that 71% of C difficile cases identified in children aged 1 to 17 years are community-associated. In adults, the reverse is true; about 75% of C difficile infections are acquired in the hospital. The study is perhaps the largest active population-based surveillance of C difficile infections in US children. 

Of those community-acquired cases in children, 73% received antibiotics, usually from a physician’s office, during the 12 weeks prior to their illness. Most of the antibiotic prescriptions were for ear, sinus, or upper respiratory infections (URIs). The most commonly prescribed agents were cephalosporins and β-lactams.

According to the CDC, about 17,000 children get a C difficile infection each year. About two-thirds of cases occur between ages 1 year and 2 years.

The American Academy of Pediatrics, in collaboration with the CDC, recently issued guidelines to help ensure judicious use of antibiotics for URIs. Both organizations are calling on all physicians who treat children to think carefully about the necessity of an antibiotic prescription before writing one.

In fact, according to a press release, the CDC has launched an initiative to reduce outpatient antibiotic prescribing by up to 20% and, thereby, reduce healthcare-associated C difficile infections by 50% over the next 5 years. The CDC claims this would translate into 20,000 saved lives, 150,000 prevented hospitalizations, and more than $2 billion in healthcare costs saved.

For more information about smart antibiotic prescribing, visit http://www.cdc.gov/getsmart/.