The rate of Clostridioides difficile infection has dropped by 24% in the United States, likely due to prevention efforts in the healthcare community, according to a new study.

The decrease in infections and associated hospitalizations from 2011 through 2017 were only seen in healthcare – not community – settings. In fact, the estimated national burden of healthcare-associated C. difficile infection decreased by 36%, while the burden of community-associated C. difficile infection remained unchanged. 

The authors attributed the declines to greater adherence to infection-prevention protocols, avoidance of inappropriate testing and better medication stewardship including reductions in fluoroquinolone use. 

In one study cited by the authors, hospitals that achieved a 30% reduction in fluoroquinolone use attained a 19% reduction in hospital-onset C. difficile infection. The research team has also observed a 55% decrease in infections tied to long-term care facilities from 2011 to 2015, and a 20% decline in hospital-onset infections from 2015 and 2017.

In the current study, estimates were adjusted to account for the effects of highly sensitive C. difficile testing capabilities newly available in that time period, reported Alice Y. Guh, M.D., and colleagues from the Centers for Disease Control and Prevention. 

Full findings were published Wednesday in the The New England Journal of Medicine.