No abstract

may be preferred because they do not require specimen batching to be cost-effective. In summary, our study in children supports previous studies in adults that reported infrequent false positivity rates for various toxin EIAs. 2 Our data challenge a previous pediatric study that anomalously reported that positive toxin EIA results are unreliable. 6 However, further work is required to understand the negative predictive value of toxin EIA results in children prior to recommending toxin EIAs as stand-alone tests for diagnosing CDI in pediatric patients.

did not mention the rationale for alternative therapy, and this approach may overestimate inappropriate prescribing. This study was observational and retrospective in nature, but it provides useful insight on ambulatory CDI management. We hypothesize that ambulatory care providers are unfamiliar with the updated recommendation to prescribe oral vancomycin first. E-mail newsletter education regarding the revised guidelines was provided to inpatient and outpatient prescribers in the health system in early 2018, but it appears to have been ineffective to communicate this practice change. Ambulatory CDI treatment may represent a missed opportunity for institutional ASPs to minimize associated morbidity. A focused effort is needed to improve the quality of CDI management in outpatient setting. Financial support. No financial support was provided relevant to this article.

No abstract