You don't need to be signed in to read BMJ Blogs, but you can register here to receive updates about other BMJ products and services via our site.

Archive for May, 2013

Changes Needed to Improve the Diagnosis and Management of CDI in Europe

22 May, 13 | by kuppell

Urgent action is needed to improve the diagnosis and management of clostridium difficile infection (CDI) in Europe according to a new report. CDI is the main cause of healthcare-associated diarrhoea in Europe and the CDI in Europe report hopes to help change the way CDI is managed across Europe at a policy level.

Written by a group of European infectious disease experts, with the support of Astellas Pharma Europe Ltd, the report points out that hospital patients with CDI are up to three times more likely to die in hospital (or within a month of infection) than those without CDI.  “CDI has an enormous impact on healthcare systems and infected patients can stay in hospital an extra 1-3 weeks at an additional cost of up to €14,000, compared with patients without CDI,” it adds.

 A number of reasons why CDI is not being well managed is identified by the report. In many countries there is an inadequate level of awareness of CDI among doctors and other healthcare workers, resulting in under-diagnosis. Where this happens treatment is delayed or omitted, leading to increased morbidity and complications in the treatment of co-existing diseases. Proactive infection control measures may also be delayed, risking further outbreaks. Additionally, only a third of European countries have a nationally recommended diagnostic test algorithm for CDI, with testing in nursing homes and the community being particularly limited.      

The report demonstrates how CDI threatens patient safety and the quality of care provided. It makes recommendations to improve CDI management, within the context of current EU policy initiatives, which call for increased awareness of the signs and symptoms of CDI to improve rates of testing and diagnosis as well as improved awareness of and compliance with guidelines for CDI therapy and infection control. The report also makes a case for the introduction of national-level surveillance systems in all Member States and increased patient education and awareness.

“It’s vital that governments see CDI management as a key indicator of patient safety and quality of care, and ensure that robust systems are in place to address it,” comments Professor Mark Wilcox, Professor of Medical Microbiology, University of Leeds and one of the CDI in Europe report authors. “CDI is a problem in hospitals and nursing homes and can be a major drain on healthcare resources. I believe implementation of the recommendations made in this Report will help improve the recognition of CDI and subsequently lead to a reduction in its incidence and impact on patients’ lives.”

A full copy of the report is available from


EAHP launch search for good practice initiatives

1 May, 13 | by kuppell

The European Association of Hospital Pharmacists (EAHP) has launched a search for examples of successful European initiatives to improve hospital pharmacy practice. The exercise is part of a project led by the EAHP Scientific Committee to create an inventory map of good practice initiatives, which they hope will provide practical support and inspiration for hospital pharmacists in EAHP member countries to embark on fresh improvement projects of their own.

The EAHP says a good practice initiative is any service improvement or innovation in hospital pharmacy conducted in the past ten years that has the possibility of transfer to other hospital pharmacy settings in Europe and encourage hospital pharmacists to take part.

Launching the exercise, Prof. Dr. Cees Neef, Chairman of the EAHP Scientific Committee, said: ‘By creating a European map of completed service development initiatives, we believe we can go some way to inspiring the next generation of innovation and improvement in hospital pharmacy across the continent. We hope all hospital pharmacies that have implemented change and improvement in the past ten years will give consideration to making a short submission for inclusion and help to build an open and accessible database of lasting value in terms of both developing new services, and enhancing the quality and safety of existing services.’

Two examples of good practice initiatives can be found on the EAHP website, one relating to a pharmacogenetics education programme in Leiden, and another a parenteral drug compounding initiative in Maastricht. The EAHP says that all examples of good practice initiatives submitted will be considered for inclusion in the inventory map, although some category areas hospital pharmacists may wish to consider include: 

  • clinical pharmacy and other HP role development 
  • clinical trials and research 
  • communication and leadership 
  • compounding/medicines production
  • education and training  
  • inter-professional and inter-sector collaboration 
  • patient safety 
  • pharmacotherapy 
  • process improvement
  • procurement, logistics and distribution 
  • resource management
  • use of technology  

The EAHP requests that initial submissions be made via their website ( by close of Friday 7th June 2013. 


Latest from European Journal of Hospital Pharmacy

Latest from European Journal of Hospital Pharmacy