A Reflection from HIS 2018: What is the main driver for C. difficile infection? Antibiotics or C. difficile acquisition?

I made a flying visit to HIS today in Liverpool to have a debate with Prof Mark Wilcox on whether or not antibiotics are the most important factor in healthcare-associated C. difficile infection. Mark was arguing for the motion, and I was arguing against it. And the result…well you’ll have to read to the bottom!

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The English C. difficile miracle: is it all about fluoroquinolones?

A new Lancet ID study suggests that restriction of fluoroquinolone usage has been the main driver of the national reduction in C. difficile infection in England. This paper is challenging in terms of some of the accepted approaches to controlling the transmission of C. difficile: if it’s all about reducing fluoroquinolones (and antimicrobials in general) and nothing to do with these measures, then why invest so much time and energy in isolation of symptomatic cases, cleaning and disinfection etc?

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