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New study reveals antibiotics, not dirty hospitals, were the main cause of UK C. difficile epidemic

Widespread overuse of common antibiotics like ciprofloxacin led to the outbreak of severe diarrhoea caused by Clostridium difficile superbug that hit headlines in the UK from 2006 onwards, according to a new study published in The Lancet Infectious Diseases journal. The study by universities of Oxford and Leeds and Public Health England found that cases of C. difficile fell only when fluoroquinolone use was restricted and used in a more targeted way as one part of many efforts to control the outbreak.

Inappropriate use and widespread over prescribing of fluoroquinolone antibiotics such as ciprofloxacin allowed C. difficile bacteria that were resistant to the drug to thrive, because non-resistant bacteria in the gut were killed off by the antibiotic, leaving the way clear for rapid growth of resistant C. difficile. The restriction of fluoroquinolones resulted in the disappearance of the infections caused by the antibiotic-resistant C. difficile, leading to around an 80 per cent fall in the number of these infections in the UK.

The researchers conclude that ensuring antibiotics are used appropriately is the most important way to control the C. difficile superbug. They note that it is important that good hand hygiene and infection control continues to be practiced to control the spread of other infections.

Reference:
Dingle KE, Didelot X, Quan TP, et al. Effects of control interventions on Clostridium difficile infection in England: an observational study. Lancet Infect Dis 2017. Published Online January 24, 2017 http://dx.doi.org/10.1016/S1473-3099(16)30514-X
Link to the publication: http://www.thelancet.com/pdfs/journals/laninf/PIIS1473-3099%2816%2930514-X.pdf

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