Structured Abstract

Contents

• Preface
• Acknowledgments
• Technical Expert Panel
• Peer Reviewers
• Introduction
  • Condition
  • Diagnosis
  • Treatment Strategies
  • Prevention
  • Scope and Key Questions
  • Organization of the Report
• Methods
  • Literature Search Strategy
• Results
  • Literature Search Results
  • KQ1 How do different methods for detection of toxigenic C. difficile to assist with diagnosis of CDI compare in their sensitivity, specificity, and predictive values?
  • KQ2 What are effective prevention strategies?
  • KQ3 What are the comparative effectiveness and harms of different antibiotic treatments?
  • KQ4 What are the effectiveness and harms of other interventions?
• Discussion
  • Overview
  • Research Gaps
  • Limitations
  • Conclusion
• References
• Abbreviations
• Appendix A Analytic Frameworks
• Appendix B Search Strings
• Appendix C Excluded Studies
• Appendix D Risk-of-Bias Assessment Form for Observational Studies
• Appendix E Description and Characteristics of Included Studies
• Appendix F Risk of Bias and Study Quality
• Appendix G Detailed Analyses
• Appendix H Strength of Evidence
• Appendix I Ongoing Studies
• Appendix J References for Appendixes

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services¹, Contract No. 290-2012-00016-I. Prepared by: Minnesota Evidence-based Practice Center, Minneapolis, MN

Suggested citation:

Butler M, Olson A, Drekonja D, Shaukat A, Schwehr N, Shippee N, Wilt TJ. Early Diagnosis, Prevention, and Treatment of Clostridium difficile: Update. Comparative Effectiveness Review No. 172. (Prepared by the Minnesota Evidence-based Practice Center under Contract No. 290-2012-00016-I.) AHRQ Publication No. 16-EHC012-EF. Rockville, MD: Agency for Healthcare Research and Quality; March 2016. www.effectivehealthcare.ahrq.gov/reports/final.cfm.

This report is based on research conducted by the Minnesota Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2012-00016-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.

The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.

AHRQ or U.S. Department of Health and Human Services endorsement of any derivative products that may be developed from this report, such as clinical practice guidelines, other quality enhancement tools, or reimbursement or coverage policies, may not be stated or implied.

This report may periodically be assessed for the currency of conclusions. If an assessment is done, the resulting surveillance report describing the methodology and findings will be found on the Effective Health Care Program Web site at www.effectivehealthcare.ahrq.gov. Search on the title of the report.

1

5600 Fishers Lane, Rockville, MD 20857; www​.ahrq.gov