MEC Minute

From Stephen Thomas, MD
Chair, Medical Executive Committee

Today’s Minute

November 4, 2024

Team Upstate:

 

Some quick thoughts regarding C. difficile:

 Cdiff Order Question

When ordering oral vancomycin or fidaxomicin for patients with C. diff PCR positive, EIA toxin negative results, DO NOT select the indication, “C. diff confirmed by both PCR and toxin”. The correct indication is “Other” and requires pharmacy approval for continuation beyond 3 days. Charts are audited and incorrect indication selections could be problematic. 

 Cdiff results

 When a BPA fires suggesting C. diff testing is not indicated, consider removing the order and investigating alternative sources for diarrhea. Approximately 70% of clinicians are overriding the BPA and testing the patient. The result is that 86% of these patients either testing negative, not being treated, or are not ultimately being tested for C. diff. 

 

Thanks for reading,

Stephen

 

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