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Community and primary care nursing
Increased risk of recurrent Clostridium difficile infection among older adults taking antibiotics and acid reducing medications
  1. Terri Kean
  1. University of Prince Edward Island, Faculty of Nursing, Charlottetown, PE, Canada, C1A 4P3
  1. Correspondence to Professor Terri Kean, University of Prince Edward Island, Faculty of Nursing, Charlottetown, PE C1A 4P3, Canada; tkean1965{at}

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Commentary on: Haran JP, Bradley E, Howe E, et al. Medication exposure and risk of recurrent Clostridium difficile infection in community-dwelling older people and nursing home residents. J Am Geriatr Soc 2018; 66(2):333–338.

Implications for practice and research

  • Increased rates of Clostridium difficile in healthcare facilities and in the community mandates comprehensive infection prevention and control (IPAC) strategies including deprescribing proton pump inhibitors and antibiotic stewardship.

  • Research to examine frailty as a predictive marker of recurrent C. difficile infections (rCDI) among older adults who take acid-reducing agents, antibiotics, and corticosteroids may provide greater clarity on the influence of the living environment.


Recognised as the leading cause of antibiotic-associated diarrhoea worldwide,1–3 C. difficile disproportionately affects older adults and confers substantial health and economic burden. The study by Haran et al draws necessary attention to rCDI among older …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.