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The Cost-efficiency and Care Effectiveness of Probiotic Administration with Antibiotics to Prevent Hospital-Acquired Clostridium difficile Infection

Starn, Emily S. DNP, FNP, RN; Hampe, Holly DSc, MHA, MRM, RN; Cline, Thomas PhD, MBA

doi: 10.1097/QMH.0000000000000110
Quality Improvement

Health care facility–acquired Clostridium difficile infections (HCFA-CDI) have increased over the last several decades despite facilities developing protocols for prescribing probiotics with antibiotics to prevent HCFA-CDI. The literature does not consistently support this. A retrospective medical record review evaluated the care effectiveness of this practice. Care effectiveness was not found; patients receiving probiotics with antibiotics were twice as likely to develop HCFA-CDI (P = .004). Except with glycopeptides, patients were 1.88 times less likely to experience HCFA-CDI (P = .05).

1203 Dutilh Rd Unit 8, Cranberry Township, Pennsylvania (Dr Starn); School of Nursing and Health Sciences, Robert Morris University, Moon Township, Pennsylvania (Dr Hampe); and Alex G. McKenna School of Business, Saint Vincent College, Latrobe, Pennsylvania (Dr Cline).

Correspondence: Holly Hampe, DSc, MHA, MRM, RN, School of Nursing and Health Sciences, Robert Morris University, 6001 University Blvd, Moon Township, PA 15108 (

This study was funded by the Jewish Healthcare Foundation, through the Alvin J. Rogal Research Award.

The authors thank the Jewish Healthcare Foundation for its generous funding through the Alvin J. Rogal Research Award. The authors also thank Laura Morris, Stephen Colodny, MD, Chief of the Infections Disease Division at St. Clair Hospital, Dan Bredl of IT, and St. Clair Hospital staff; Heather Smith for paving the way for this project with “Risk Factors for HCFA-CDI”; and a recommendation for further study, Meghan Holohan for editing and suggestions with the writing. In addition, the corresponding author offers sincere gratitude to her family, friends, and Robert Morris University faculty for their support and guidance throughout this project and her education.

The authors declare no conflicts of interest.

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