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This quasi-experimental pre–post study assessed the clinical impact of implementing a CDI-specific clinical pathway at two Spanish hospitals across three periods: historical, educational-ASP, and intervention. A CDI-specific measures bundle reduced first recurrence in high-risk groups and lowered recurrent-episode readmissions and 30-day mortality.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/clinical-impact-of-implementing-a-specific-clinical-pathway-for-the-management-of-clostridioides-difficile-infection/459672/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/clinical-impact-of-implementing-a-specific-clinical-pathway-for-the-management-of-clostridioides-difficile-infection/459672.png","ImageObject",300,407,{"name":92,"@type":93},"Quinn Holloway","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-28","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What study objective was assessed for CDI management?","Question",{"text":113,"@type":114},"To evaluate the clinical impact of implementing a specific clinical pathway for managing CDI at two Spanish hospitals.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What clinical pathway measures were included in the intervention?",{"text":118,"@type":114},"Measures included updated local CDI guidelines, 24/7 diagnostic testing with real-time notification to the ASP-CDI team, systematic evaluation of new cases, optimized antibiotic treatment and overall management, and structured follow-up until 8 weeks post-treatment.",{"name":120,"@type":111,"acceptedAnswer":121},"How did outcomes change after implementing the CDI-specific clinical pathway?",{"text":122,"@type":114},"First CDI recurrence rates declined in high-risk groups, and hospitalization during recurrent CDI episodes and mortality were significantly reduced during the pathway period.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},459672,1791093506,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":36,"preview_page_count":4},2336474466712,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Infect Dis Ther (2026) 15:85–100  \n[https://doi.org/10.1007/s40121-025-01261-9](https://doi.org/10.1007/s40121-025-01261-9)  \nORIGINAL RESEARCH  \nClinical Impact of Implementing a Specific Clinical Pathway for the Management of Clostridioides difficile Infection  \nMiguel Rodríguez‑Fernández · Rocio Herrero · Pilar González‑De‑La‑Aleja · María Dolores Valverde‑Fredet · María‑Paz Ventero · Marta Trigo‑Rodríguez · Livia Giner · Ana Isabel Aller‑García · Héctor Pinargote‑Celorio · Reinaldo Espíndola‑Gómez · Mónica Parra · Pedro Martínez Pérez‑Crespo · José‑Manuel Ramos‑Rincón · Antonio Fernández‑Pevida · Joaquín Lanz‑García · Eva León · Lucía Valiente‑De‑Santis · Juan E. Corzo · Juan‑Carlos Rodríguez · Esperanza Merino · Nicolás Merchante  \nReceived: September 13, 2025 / Accepted: October 24, 2025 / Published online: November 7, 2025 © The Author(s) 2025  \nABSTRACT  \nIntroduction: Despite Clostridioides difficile infection (CDI) being a leading healthcare‑ associated infection with high morbimortality, there is little evidence on specific antimicrobial  \n\n| Esperanza Merino and Nicolás Merchante contributed equally to this work. |\n| --- |\n| Supplementary Information The online version contains supplementary material available at [https://doi.org/10.1007/s40121](https://doi.org/10.1007/s40121)‑025‑01261‑9. |\n\nM. Rodríguez‑Fernández · R. Herrero ·  \nM. D. Valverde‑Fredet · M. Trigo‑Rodríguez ·  \nA. I. Aller‑García · R. Espíndola‑Gómez ·  \nP. Martínez Pérez‑Crespo · A. Fernández‑Pevida ·  \nJ. Lanz‑García · E. León · L. Valiente‑De‑Santis ·  \nJ. E. Corzo · N. Merchante (*) Unidad de Enfermedades Infecciosas y  \nMicrobiología, Hospital Universitario de Valme. Universidad de Sevilla. Instituto de Biomedicina de Sevilla, IBiS (Universidad de Sevilla, Junta de Andalucía, CSIC), Seville, Spain  \ne‑[mail: nicolasmerchante@gmail.com](mail: nicolasmerchante@gmail.com)  \nP. González‑De‑La‑Aleja · M.‑P. Ventero · L. Giner ·  \nH. Pinargote‑Celorio · M. Parra · J.‑M. Ramos‑Rincón · J.‑C. Rodríguez · E. Merino  \nUnidad de Enfermedades Infecciosas y Microbiología, Hospital General Universitario Dr. Balmis. Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL) . Universidad Miguel Hernández, Alicante, Spain  \nstewardship program (ASP) interventions for CDI. The objective of this study was to assess the clinical impact of implementing a specific clinical pathway for CDI management at two Spanish hospitals.  \nMethods: This was a quasi‑experimental pre– post intervention study, and three periods were evaluated: historical (2014–2017), educational‑ ASP (2018–2020), and intervention (2021–2023), after implementation of a CDI‑specific measures bundle. Key measures included: (1) updated local CDI guidelines; (2) 24/7 diagnostic testing and real‑time positive results notification to ASP‑CDI team; (3) systematic evaluation of new cases; (4) optimizing CDI antibiotic treatment and overall management; and (5) structured follow‑up until 8 weeks post‑treatment. Primary outcome was first CDI recurrence, and secondary outcomes  \nwere readmissions during recurrent CDI episodes and 30‑day all‑cause mortality.  \nResults: In total, there were 1435 patients with CDI included: 370 in the historical period (2014–2017), 537 in the educational‑ASP period (2018–2020), and 528 in the CDI‑specific clini‑ cal pathway period (2021–2023) . First CDI recurrence rates significantly declined across periods in high‑risk groups: immunocompro‑ mised patients, 29% in 2014–2017, 22% in 2018–2020, and 15% in 2021–2023 (p = 0.038); those with severe/fulminant initial CDI, from 38% to 34% to 24%(p = 0.027); and patients aged 65–79 years, from 29% to 31% to 13%(p = 0.003) . Hospitalization during recurrent CDI episodes and mortality were significantly reduced in the CDI‑specific clinical pathway period: readmissions, 11%(2014–2017), 13%(2018–2020), and 6%(2021–2023) (p = 0.017); mortality, 7%, 6%, and 4%(p = 0.023) . Conclusions: The implementation of a struc‑ tured, multif","cbCaisaz27VTVk5w","https://ap.wps.com/l/cbCaisaz27VTVk5w","pdf",909817,16,"English","# Abstract\n## Introduction\n## Methods\n## Results\n## Conclusions\n# Introduction","[{\"question\":\"What study objective was assessed for CDI management?\",\"answer\":\"To evaluate the clinical impact of implementing a specific clinical pathway for managing CDI at two Spanish hospitals.\"},{\"question\":\"What clinical pathway measures were included in the intervention?\",\"answer\":\"Measures included updated local CDI guidelines, 24/7 diagnostic testing with real-time notification to the ASP-CDI team, systematic evaluation of new cases, optimized antibiotic treatment and overall management, and structured follow-up until 8 weeks post-treatment.\"},{\"question\":\"How did outcomes change after implementing the CDI-specific clinical pathway?\",\"answer\":\"First CDI recurrence rates declined in high-risk groups, and hospitalization during recurrent CDI episodes and mortality were significantly reduced during the pathway period.\"}]","Clinical Impact of Implementing a Specific Clinical Pathway for the Management of Clostridioides difficile Infection | PDF",1790756564]