Impact of Order Set Implementation on Institutional Management of Clostridioides difficile in Adult Patients

In February 2022, the University of Rochester Medical Center (URMC) updated their practice guidelines, in accordance with the Infectious Diseases Society of America, to include fidaxomicin as the preferred agent in patients with initial (non-fulminant) or first recurrence of C. difficile infection (CDI). Health system protocols were updated to include polymerase chain reaction (PCR) testing for patients with suspected CDI followed by confirmation via toxin enzyme immunoassay (EIA). In the appropriate clinical context, PCR+/EIA+ test confirms active CDI and warrants antibiotic treatment. PCR+/EIA- test indicates likely colonization and may preclude the need for treatment. A CDI order set was implemented in May 2023 to facilitate guideline adherence