Cdiff question

[ss234, BSN, RN]

If a person is experiencing diarrhea while taking an antibiotic at what point do you test for cdiff? More specifically, if a patient has only had 3 episodes of diarrhea in 24 hours could they still have cdiff or is it usually more?

[CalicoKitty, BSN, MSN, RN]

I think part of testing for cdiff includes ruling out 'other explanations'. Granted, I see doctors order the test the days right after starting patients on tube feeds. At some hospitals, simply requesting the test puts the patient on isolation.

[0.9%NormalSarah, BSN, RN]

3 episodes of diarrhea in 24 hours could absolutely be the start of C diff. Does your facility have a policy? Does the patient have other risk factors? Other antibiotics recently, elderly, etc? Depending on the whole clinical picture the provider could order the tests, but they would immediately be in isolation at most places as Calico said. Then it’s 3 negative stool samples to rule out.

[Cowboyardee]

The number of loose bowel movements is not particularly the decisive factor.

C diff infection will most often be accompanied by a fever and/or leukocytosis in a patient who doesn't have other conditions that would suppress these findings.

Presence of unexplained fever and elevated WBCs might be good enough reasons to test for c diff in a patient who has only one loose stool. Absence of these findings along with some other known source of loose bowel movements might be reason not to test in a patient having many, many loose stools.

[Kitiger, RN]

C diff has a very distinctive odor. Absence of that odor does not rule it out, but smelling THAT along with 3 episodes of diarrhea in 24 hours would be a good reason to test for it.

[Davey Do]

3 minutes ago, Kitiger said:

C diff has a very distinctive odor.

[ruby_jane, BSN, RN]

Is this a question about personal issues? If so, then you need to consult your physician; we're not allowed to give medical or nursing advice. If I've misunderstood, consult your agency's policy for the answer. Good luck!