Are hospitalists taking C. diff seriously enough? Maybe, maybe not

Clostridium difficile has been on the radar of infectious disease (ID) experts for the better part of a decade now. But how mindful are hospitalists of the problem, and how seriously are they taking it?

“I think we’re getting there,” says Danielle Scheurer, MD, MSCR, SFHM, a hospitalist and medical director of quality at the Medical University of South Carolina in Charleston. But she adds, “Because the bugs are invisible, you feel a little bit disconnected from your direct role in all this.”

Stuart Cohen, MD, an ID expert at the University of California Davis and a fellow with the Infectious Diseases Society of America, says not everyone is as concerned about C. diff as they should be.

“I think most people still see C. diff as just basically being a nuisance, and so they don’t really take it quite so seriously. Until somebody sees a patient have to get a colectomy or die from C. diff, I don’t think that there’s necessarily an appreciation to the severity of the illness,” he says. “You don’t really get this sense that it’s anything other than, ‘Well, we’ll just give them some vancomycin or we’ll just give them some metronidazole and we’ll take care of it.’”

Ketino Kobaidze, MD, a hospitalist at Emory University Hospital Midtown in Atlanta, says she thinks hospitalists should be more involved in antibiotic stewardship efforts and in research efforts to combat C. diff.

“I’m sure everybody knows and everybody takes it into consideration,” she says. But she also says not all hospitalists view C. diff as an acute problem that warrants urgent treatment “or we might be in trouble,” she says. “I’m not sure about that.”

Dr. Scheurer says the solution to treating C. diff properly is keeping a mindset on the safety of your patients. “Then it can motivate you and your group,” she says. “Every single number affects a person. It’s not just a rate. Zero is the goal.”

Tom Collins is a freelance medical writer based in Florida.