A qualitative study to identify reasons for Clostridium difficile testing in pediatric inpatients receiving laxatives or stool softeners

Published:March 13, 2017DOI:


      • Clinicians often test for C. difficile despite knowing patients are on laxatives.
      • Reasons for testing include increased loose stool or change in clinical status.
      • Prior CDI, antibiotic receipt, and comorbidities also influence decisions to test.
      • Targeted education is needed about testing after receipt of bowel medications.
      To understand why clinicians send Clostridium difficile tests from hospitalized children receiving laxatives or stool softeners, we performed a mixed-methods study. We prospectively identified tested patients and surveyed their clinicians by e-mail. Reasons for testing included changes in stooling pattern on baseline bowel regimen, other changes in clinical status, and risk factors for C difficile infection. Education targeting discontinuing bowel medications before C difficile testing could improve the specificity of pediatric C difficile infection diagnosis.

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