Sunday, October 14, 2007

I've been bugged

Your humble Devil was contemplating writing a rather more technical post on Clostridium difficile; fortunately, I don't have to as... [drum roll]... Dr Crippen is back to do it for me!
A few words on Clostridium Difficile.

It has been around for years. It is rare. Contrary to what the media would have you believe, it is not caused by poor hygiene. Just as MRSA lives happily up your nose without causing problems, so C.Difficle lives happily in your colon until the bacteriological environment of the colon is changed. And it is usually changed by an inexperienced junior hospital doctor prescribing a long and inappropriate course of broad spectrum antibiotics. Elderly women frequently get urinary tract infections. Mostly, they can be cured by six tablets of trimethoprim, one twice a day for three days. Cheap, cheerful, narrow spectrum and harmless. But give an inappropriate dose of what inexperienced doctors and nurses tend to view as a “stronger” antibiotic and the balance of the gut flora is disturbed and C.Difficle takes over. (A simple guide to C.Difficile here)

By the way, a quick word on dichotomous naming: as you doctors should know, the second section of the name is not capitalised.

Call me a pedant if you like, but it is Clostridium difficile not Clostridium Difficile...

7 comments:

Andrew K said...

It is also Latin, not French. So it is Clostridium di-FFIK-i-lay, not Clistridium diffi SEAL.

Anonymous said...

trimethoprim isn't completely harmless, http://www.emedicine.com/med/topic3412.htm

"And it is usually changed by an inexperienced junior hospital doctor prescribing a long and inappropriate course of broad spectrum antibiotics."

mmm, a bit of speculation here, a little unfair on junior doctors.

in fact in my experience junior doctors are pretty up to date with their prescribing and pretty responsible with their antibiotics.

I think GPs are hardly blamefree in this area, it's not just the easy scapegoat of the junior doctor, how many GPs dish out cephalosporins inappropriately?

Anything to do with Dr C being a GP??

Mark Wadsworth said...

Nice pedantry at the end!

Letters From A Tory said...

Nice to listen to someone who actually knows what they're talking about - a sadly rare occurence in politics.

Roger Thornhill said...

If it is significantly due to prescription behaviour, what on EARTH is actually going on?

Do most doctors keep quiet?
Are doctors being ignored?
Are Trust CEOs complete numpties?
The BBC just swallows whatever it is given, like hapless patients?

the a&e charge nurse said...

For obvious reasons c-diff is a very worrying HAI - patients have been dying from it before the Kent debacle was publicised.

28 patients died in Leicester in 2006 after being infected, 21 other deaths were linked to c-diff [a further 29 cases were referred to the coroner].

It is believed the particular strain of c-diff [o27] had been imported from North America.

Microbiologists have been warning for some time now that an organism resistant to ALL known antibiotics may be just around the corner ?

mike power said...

Contrary to what the media would have you believe, it is not caused by poor hygiene.

I can't recall seeing any reports claiming that c. diff is CAUSED by poor hygiene. It is SPREAD by poor hygiene. That fact is incontestable.

Call me a pedant if you like, but it is Clostridium difficile not Clostridium Difficile...

Mmmm. Are you getting enough sex Mr D?