To understand the experiences, practices, and challenges of infectious diseases clinicians in managing Clostridioides difficile infection (CDI) following updated guidelines, particularly in light of new therapies.
Key Findings:
83% of 500 respondents indicated vancomycin as their most frequently prescribed agent for initial, nonfulminant CDI.
72% reported institutional guidelines recommending vancomycin as the first-line agent.
82% cited outpatient insurance coverage challenges as a barrier to fidaxomicin use.
87% had recommended fecal microbiota transplantation (FMT) for recurrent CDI, but only 48% had access to it.
Fecal microbiota live-jslm and fecal microbiota spores live-brpk were available to 36% and 30% of respondents, respectively.
Interpretation:
Despite updated guidelines favoring fidaxomicin and bezlotoxumab, vancomycin remains the most commonly prescribed treatment due to cost, accessibility issues, and insurance barriers.
Limitations:
The survey had a response rate of 36%, which may not fully represent the views of all ID clinicians, and not all respondents answered every question, leading to varying denominators in the results.
Conclusion:
Understanding clinician practices and barriers is crucial for improving access to and optimizing CDI management, particularly in addressing the financial and logistical challenges faced by clinicians.
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