Associations between antimicrobial stewardship program elements andClostridium difficileinfection performance

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HighlightsMore hospitals with non-better Clostridium difficile rank used prospective audit and feedback.More better C difficile rank hospitals used a preauthorization strategy.More better C difficile rank hospitals restricted more high-risk antibiotics.Hospitals are categorized as better, no different, or worse at a national level based on their Clostridium difficile infection performance. Institutional antimicrobial stewardship programs seek to decrease the occurrence of C difficile by implementing strategies to address antibiotic usage; however, optimal structure and strategies for accomplishing this remain largely unknown. We found that a higher proportion of hospitals with either a worse or no different rank used a postprescription audit and feedback strategy than hospitals with a better rank.

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