[Identifying gaps between guidelines and clinical practice in XXXX infection].

@entity1 @entity2718 @entity166
OBJECTIVES: The first aim was to determine whether @entity1 are being treated in accordance with the Society for Healthcare Epidemiology of America and the @entity166 Society of America (IDSA/SHEA) @entity2718 guidelines and whether adherence impacts @entity1 outcomes. The second aim was to identify specific action items in the guidelines that are not being translated into clinical practice, for their subsequent implementation. MATERIAL AND METHODS: A retrospective, descriptive study was conducted over a 36 month period, on @entity1 with compatible clinical symptoms and positive test for @entity2718 toxins A and/or B in stool samples, in an internal medicine department of a tertiary medical centre. @entity1 demographic and clinical data (outcomes, comorbidity, risk factors) and compliance with guidelines, were examined RESULTS: A total of 77 @entity1 with @entity2718 infection were identified (87 episodes). Stratified by disease severity criteria, 49.3% of @entity1 were mild-moderate, 35.1% severe, and 15.6% severe-complicated. Full adherence with the guidelines was observed in only 40.2% of @entity1 , and was significantly better for mild-moderate (71.0%), than in severe (7.4%) or severe-complicated @entity1 (16.6%) (P<.003). Adherence was significantly associated with clinical cure (57% vs 42%), fewer recurrences (22.2% vs 77.7%), and mortality (25% vs 75%) (P<.01). The stratification of severity of the episode, and the adequacy of antibiotic to clinical severity, need improvement. CONCLUSIONS: Overall adherence with the guidelines for management of @entity2718 infection was poor, especially in severe and severe-complicated @entity1 , being associated with worse clinical outcomes. Educational interventions aimed at improving guideline adherence are warranted.
