Aaron J. Calderon, MD, FACP, SFHM

This model helps to predict recurrent infection, but taking steps to avoid infections is more important.

Recurrent Clostridium difficile infection (CDI) is experienced by approximately 20% of patients who suffer initial CDIs. Preventing recurrent CDIs, potentially with novel therapies, rests on our ability to identify high-risk patients during their initial presentations.

In a single-institution, retrospective cohort study, researchers developed a bedside prediction model for recurrent CDI, based on risk factors that are readily identifiable during initial CDI episodes. Recurrent CDI was defined as a positive toxin assay within 42 days of treatment for an initial episode of CDI. Between 2003 and 2010, approximately 4200 patients suffered initial CDIs, and 10% developed recurrent CDIs. In a multivariate analysis, six factors (community-onset, healthcare-associated case status; ≥2 hospitalizations within 60 days; new gastric acid suppression; fluoroquinolone use; other high-risk antibiotic use; and older age) were moderately predictive of recurrent CDI.

Citation(s):

Zilberberg MD et al. Development and validation of a recurrent Clostridium difficile risk-prediction model. J Hosp Med 2014 Jul; 9:418.