It’s just a bit of diarrhoea…or is it? Tackling the C. diff challenge

“Tackling the rising rates of C. difficile (C.diff) infections will save lives, prevent unnecessary hospital admissions due to recurrent infection, and ease the pressures on our healthcare system. Let’s bring this infection under control".

?It’s just a bit of diarrhoea…or is it? Tackling the C. diff challenge

Tillotts Pharma UK Managing Director ?Jeremy Thorpe shares his perspective on the UK’s C. diff challenge.

Diarrhoea is often short-term but, in some cases, it signals a much more serious condition [1,2], such as Clostridioides difficile (C. diff) which can be life-threatening in vulnerable patients. [2] [3]. Antibiotic use and older age are? major risk factors for causing C. diff infection[2], making awareness particularly crucial as we approach the peak antibiotic-prescribing months of winter [4].

C. diff infection rates have decreased markedly since 2007/2008, following improvements in hospital infection control measures and stricter antibiotic prescribing protocols [5]. However, this progress is now under threat, with C. diff rates reaching a 10-year high in 2023 [6]. It's tragic that more people are entering hospital for routine treatment and acquiring a life-threatening infection than they were 10 years ago.

When patients acquire C. diff in hospitals, the infection is associated with increased hospitalisation costs, which increase with recurrent infections. In fact, after being diagnosed with C. diff the first time, patients have a 25% chance of? being diagnosed a second time and a 40% chance of being diagnosed a third time [7,8].

The resurgence of C. diff infections places strain on the NHS, causing bed blocking, prolonged hospital stays, and recurrent infections. Patients with C. diff require isolation and extended care, which directly contributes to overcrowding and reduced hospital efficiency. The financial burden is equally significant, with each recurrent C. diff infection estimated to cost the NHS over ￡30,000 [9].

The inconsistency of testing across the UK further complicates the issue [10]. Without comprehensive testing, cases may go undiagnosed, exacerbating the spread of infection and contributing to potentially avoidable fatalities. It is important that when a patient presents with diarrhoea, the possibility that it may have an infectious cause is considered [11]. Early detection may save lives.

With November marking C. diff Awareness Month, we at Tillotts UK are proposing collaborative approaches to prevent, diagnose, and treat C. diff, as well as address the inequalities associated with its increasing prevalence. I truly believe it is essential that we come together to tackle this? issue and implement the following actions: 1) improved awareness and understanding; 2) greater focus on testing; and 3) a coordinated approach to reducing geographic variations and inequalities.

C. diff infections are largely preventable. By addressing these issues at the source, we can protect vulnerable patients and reduce the burden on the NHS. Tackling the rising rates of C. difficile infections will save lives, prevent unnecessary hospital admissions, and ease the pressures on our healthcare system. Let’s bring this preventable challenge under control.

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?References

?[1] NHS. Diarrhoea and vomiting. Available at https://www.nhs.uk/conditions/diarrhoea-and-vomiting/ [Accessed October 2024].

[2] NHS. Clostridium difficile (C. diff) infection. Available at https://www.nhs.uk/conditions/c-difficile/ [Accessed October 2024].

[3] Olsen et al. Clin Microbiol Infect 2015; 21: 164–170

[4] Antibiotic Resistance Research UK. Antibiotic prescribing by GPs in England fell by 17% during the first 12 months of Covid without the usual winter increase. Available at https://www.antibioticresearch.org.uk/antibiotic-research-uk-calls-for-change-in-behaviour-to-reduce-antibiotic-prescribing-launches-new-campaign-whats-bugging-you-this-winter/ [Accessed October 2024].

[5] National Institute for Health and care Excellence (NICE). Clostridium difficile infection: risk with broad-spectrum antibiotics. Available at https://www.nice.org.uk/advice/esmpb1/chapter/key-points-from-the-evidence [Accessed October 2024].

[6] UK Health Security Agency. Annual epidemiological commentary: Gram-negative, MRSA, MSSA bacteraemia and C. difficile infections, up to and including financial year 2022 to 2023. Available at https://www.gov.uk/government/statistics/mrsa-mssa-and-e-coli-bacteraemia-and-c-difficile-infection-annual-epidemiological-commentary/annual-epidemiological-commentary-gram-negative-mrsa-mssa-bacteraemia-and-c-difficile-infections-up-to-and-including-financial-year-2022-to-2023 [Accessed October 2024].

[7] Tsigrelis C. Recurrent?Clostridioides difficile?infection: Recognition, management, prevention. Cleve Clin J Med. 2020 Jun;87(6):347-359.

[8] Meehan. World J Clin Infect Dis, 2016

[9] Tresman J Antimicrob Chemother 2018; 73: 2851–2855 doi:10.1093/jac/dky250

[10] Cocco Identifying Clinical Needs for New Diagnostic Tests for Clostridioides Difficile Infection: Results from a Survey of UK Healthcare Professionals

?[11] Department of Health. Clostridium difficile infection: How to deal with the problem. Available at https://assets.publishing.service.gov.uk/media/5a7edda9e5274a2e8ab48b25/Clostridium_difficile_infection_how_to_deal_with_the_problem.pdf [Accessed October 2024].

NU-02558? | Oct 2024

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