Association Between Reporting Antimicrobial Use and Clostridioides difficile Standardized Infection Ratios in South Carolina Hospitals

The Centers for Disease Control and Prevention have been encouraging hospitals in the United States to report antimicrobial use (AU) to the National Healthcare Safety Network (NHSN). This retrospective cohort study examines the association between reporting AU and the <i>Clostridioides difficile</i> infection (CDI) standardized infection ratio (SIR) in South Carolina hospitals. Student's <i>t</i>-test was used to examine the mean difference in the change in CDI SIRs from 2017 to 2021 between hospitals reporting AU for ≥3 years and those reporting AU for <3 years during the study period. Among 65 hospitals in South Carolina, 43 reported AU for <3 years, and 22 reported AU for ≥3 years. There was significantly greater decline in the CDI SIR from 2017 to 2021 in hospitals reporting AU for ≥3 years compared to those reporting AU for <3 years (mean difference of the change in the CDI SIR -0.33 [95% CI -0.57, -0.06]; <i>p</i> = 0.016). The results of a steeper decline in the CDI SIR in hospitals consistently reporting AU during the majority of the study period compared to other hospitals encourages hospitals to report AU to the NHSN and promotes antimicrobial stewardship efforts at the state and national level.