Prevention and control
This is a summary of issues.
Antibiotic usage
- First and foremost, use antibiotics judiciously; evaluate use of fluoroquinolones, other antibiotics, and additional medications such as proton pump inhibitors if an endemic rate is high or a cluster is suspected.
- If feasible, discontinue the antibiotic(s) the patient was receiving prior to onset.
Precautions
- Use Contact Precautions for patients with known or suspected CDAD according to current CDC guidelines:
- Place these patients in private rooms. If private rooms are not available, these patients can be placed in rooms with other patients (cohorted) with C. difficile-associated disease.
- Hand Hygiene
- Perform hand hygiene using either an alcohol-based hand rub or soap and water.
- Outbreak: If your institution experiences an outbreak, consider using only soap and water for hand hygiene when caring for patients with C. difficile-associated disease; alcohol-based hand rubs may not be as effective against spore-forming bacteria.
- Commentary/Update on hand hygiene, Safety Share News
- Perform hand hygiene using either an alcohol-based hand rub or soap and water.
- Outbreak: If your institution experiences an outbreak, consider using only soap and water for hand hygiene when caring for patients with C. difficile-associated disease; alcohol-based hand rubs may not be as effective against spore-forming bacteria.
- Use gloves when entering patients' rooms and during patient care.
- Use gowns if soiling of clothes is likely.
- Dedicate equipment whenever possible.
- Continue these precautions until diarrhea ceases.
Environmental cleaning and disinfection
- Implement an environmental cleaning and disinfection strategy:
- Ensure adequate cleaning and disinfection of environmental surfaces and reusable devices, especially items likely to be contaminated with feces and surfaces that are touched frequently.
- Use an Environmental Protection Agency (EPA)-registered hypochlorite-based disinfectant for environmental surface disinfection after cleaning in accordance with label instructions; generic sources of hypochlorite (e.g., household chlorine bleach) also may be appropriately diluted and used. (Note: alcohol-based disinfectants are not effective against C. difficile and should not be used to disinfect environmental surfaces.)
- Follow the manufacturer's instructions for disinfection of endoscopes and other devices.
- Infection control practices in long term care and home health settings are similar to those practices taken in traditional health-care settings.