C. diff precautions
Formal Definition
Contact isolation precautions implemented for patients with confirmed or suspected Clostridioides difficile (C. diff) infection; requires gloves and gown for all contact with the patient or their environment, private room placement when available, and hand washing with soap and water (not alcohol gel) due to alcohol-resistant spore formation.
How It's Used on the Ward
"The patient is on C. diff precautions" or "CDI precautions" — isolation protocol that significantly impacts patient care logistics and room assignments.
Example
""Day 4 patient with 8 watery stools, prior hospitalization 6 weeks ago with antibiotic exposure: C. diff PCR ordered, placing on contact precautions now, handwashing with soap and water mandatory — alcohol gel doesn't kill spores.""
Clinical Context
C. diff spores survive on surfaces for months and are resistant to alcohol-based hand sanitizers — soap and water is mandatory. Gown and gloves for all room entry. Private room preferred; cohort if not available. Treatment: fidaxomicin (preferred) or vancomycin PO; metronidazole only for mild CDI when others unavailable. Avoid antiperistaltics (loperamide). Risk factors: antibiotic exposure (especially clindamycin, fluoroquinolones, broad-spectrum beta-lactams), PPIs, age > 65, immunosuppression, prior CDI.
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