Trust Board Febuary 2010 - Sandwell & West Birmingham Hospitals

SWBTB (2/10) 038 (a)
Median rate 2.87
Best quartile rate 1.92
Clostridium difficile Infections (CDI)
There were 59 cases of CDI in patients admitted to the Trust during the period October to
December 2009, of which 42 were diagnosed after 48 hours and are attributable to our trajectory
(Figure 2). This is well within our threshold of 54 cases for that quarter.
Figure 2. Clostridium difficile cases >48 hours
30
20
10
0
A p r - 0 8
M a y - 0 8
J u n -0 8
J u l- 0 8
Antibiotic Stewardship
A u g -0 8
S e p -0 8
O ct- 0 8
N o v -0 8
D e c -0 8
J a n -0 9
Sandw ell City Trust Target Trajectory - Int
F e b - 0 9
M a r - 0 9
A p r - 0 9
M a y - 0 9
J u n -0 9
J u l- 0 9
A u g -0 9
S e p -0 9
O ct- 0 9
N o v -0 9
D e c -0 9
J a n -1 0
F e b - 1 0
M a r - 1 0
This has been another productive period for the Antibiotic Management Team. It saw the launch of
the revised Trust guideline for the management of commonly encountered infections which for the
first time gives a range of different options for vulnerable elderly patients who are likely to receive
repeated courses of antibiotics and are particularly at risk of developing infections due to antibiotic
resistant bacteria or CDI. The compliance with this new guidance is currently being audited and a
report should be available in the near future.
At a time when recommendations for antibiotic usage are changing, it is particularly important to be
able to rapidly review the impact of these changes on prescribing patterns, and the figure shows an
example of the reports now being compiled monthly which gives a simple visual indication of the
previous month’s prescribing compared to the average usage over the previous year. Of course
this type of data requires interpretation of any changes in the light of what might be expected e.g.
an increase in the antibiotics predominantly used for chest infections during the winter months, or
increases in agents which are being encouraged through various guidelines.