Antibiotic Suspensions Research Articles

The gut microbiota regulates diabetic retinopathy in adult rats

IntroductionDiabetic retinopathy (DR) is the most common complication of diabetes. Neuronal apoptosis, activated microglia, and microvascular changes are early features of DR. The gut microbiota is critical for the maturation and activation of microglia in the brain, and DR patients exhibit gut dysbiosis. However, the effect of the gut microbiota on retinal microglia under normal or diabetic conditions is still unclear.MethodsType 2 diabetes (T2D) was established in male adult Brown Norway (BN) rats, and they were treated with gavage of broad-spectrum antibiotic (ABX) suspension. Retinal fundus fluorescein angiography was performed to observe the dynamic growth process and leakage of blood vessels. Retro-orbital injection of FITC-Dextran was performed to observe the changes in blood-retinal barriers. After treatment with ABX and diabetes lasting for more than 6 months, 16S RNA sequencing of stool samples was performed to determine changes in the gut microbiome and mass spectrometry was used to analyze metabolome changes. IBA1, IB4, and Brn3 staining were performed on adult rats’ retinal wholemount or sections to observe the changes in microglia, blood vessels and the number of ganglion cells.ResultsLong-term (6 months) T2D caused gut dysbiosis with increased average taxa numbers. We showed that broad-spectrum antibiotics (ABXs) gavage can reduce the average number of gut microbiota taxa and retinal microglia in adult male BN rats with or without T2D. Interestingly, adult male BN rats with T2D for more than 6 months showed a loss of retinal ganglion cells (RGCs) without significant changes in retinal microglia or retinal vascular vessels. However, ABX gavage reduced retinal microglia and alleviated RGC damage in these T2D rats.ConclusionOur data suggests that ABX gavage-induced gut dysbiosis can reduce retinal microglia in adult rats and alleviate RGC loss in long-term T2D rats. Targeting the gut microbiota may be a future therapeutic strategy for DR management.

Selective decontamination of the digestive tract in a burns unit reduces the incidence of hospital-acquired infections: A retrospective before-and-after cohort study

ObjectiveTo evaluate the effect of selective decontamination of the digestive tract (SDD) on hospital-acquired infections (HAIs) in patients with acute burn injury requiring admission to a Burns Unit (BU). DesignRetrospective before-and-after cohort study, between January 2017 and June 2023. SDD was implemented in March 2019, dividing patients into two groups. SettingFour-bed BU, in a referral University Hospital in Spain. PatientsAll the patients admitted during the study period were eligible for analysis. Patients who died or were discharged within 48hours of admission, and patients with an estimated survival less than 10% not considered for full escalation of therapy were excluded. InterventionSDD comprised the administration of a 4-day course of an intravenous antibiotic, and an oral suspension and oral topical paste of non-absorbable antibiotics during the stay in the BU. Main variable of interestIncidence of HAIs during the stay in the BU. Secondary outcomes: incidence of specific types of infections by site (bacteremia, pneumonia, skin and soft tissue infection) and microorganism (Gram-positive, Gram-negative, fungi), and safety endpoints. ResultsWe analyzed 72 patients: 27 did not receive SDD, and 45 received SDD. The number of patients who developed HAIs were 21 (77.8%) and 21 (46.7%) in the non-SDD and the SDD groups, respectively (p=0.009). The number of hospital-acquired infectious episodes were 2.52 (1.21–3.82) and 1.13 (0.54–1.73), respectively (p=0.029). ConclusionsSDD was associated with a reduced incidence of bacterial HAIs and a decrease in the number of infectious episodes per patient.

Reconstitution of oral antibiotic suspensions for paediatric use in households: a cross-sectional study among caregivers of 3–5-year-old children from a selected district, Sri Lanka

IntroductionReconstitution of oral pediatric antibiotic suspension by primary caregivers plays an essential role in determining the overall health outcome of the child. Incorrect reconstitution techniques could lead to underdosing, overdosing, or introduction of infection. Underdosing could lead to non-resolving infection and antimicrobial resistance.ObjectivesTo assess the practice and associated factors on reconstitution of oral pediatric antibiotic suspensions (OPAS) among primary caregivers of 3–5-year-old children in a selected district in Sri Lanka.MethodsA cross-sectional study was carried out among 835 primary caregivers selected using two-stage cluster sampling at field clinics to assess practices for the reconstitution of OPAS. A live demonstration of the reconstitution of the OPAS was assessed by a checklist. Associated factors with caregiver practices on reconstitution were assessed using Chi-square with the statistical significance level set at 0.05.ResultsA total of 820 respondents were recruited and completed the study (response rate = 98.2%). Overall, 56.0% displayed good performance in the demonstration of reconstitution of oral pediatric antibiotic suspension. Poorest performances were observed in shaking the bottle to loosen the powder (Correct: 53.7%), topping up the bottle with water up to the marked line (Correct: 58.0%), and filling the water below the marked line in the bottle (Correct: 59.0%). Caregivers in urban areas compared to rural and estate regions (45.6% vs. 22.7% and 26.5% respectively) and caregivers aged 35 years or above compared to less than 35 years age group (31.5% vs. 22.5%) performed the reconstitution of OPAS poorly. Parental factors, namely age, gender, level of education, and geographical region (urban/rural/estate) were significantly associated with the performance in reconstituting the oral paediatric antibiotic suspension (p = 0.002, p < 0.001, p < 0.001, and p < 0.001 respectively). Factors related to the child, specifically whether they attend preschool and whether they have an older sibling, were found to have a significant association with the correct execution of the reconstitution of OPAS (p = 0.017, and p = 0.030 respectively).Conclusions and recommendationsA significant number of primary caregivers displayed poor practice in key steps during the reconstitution of OPAS, which could have a negative impact on the health of the child. Targeted place-based behavioural change health programs with the use of infographic leaflets/ posters may correct the practices of caregivers.

Usefulness of Procalcitonin in the Suspension of Antibiotics

Usefulness of Procalcitonin in the Suspension of Antibiotics

"Usefulness of Procalcitonin in the Suspension of Antibiotics"

"Usefulness of Procalcitonin in the Suspension of Antibiotics"

Total Flavonoids of Aurantii Fructus Immaturus Regulate miR-5100 to Improve Constipation by Targeting Fzd2 to Alleviate Calcium Balance and Autophagy in Interstitial Cells of Cajal.

Aurantii Fructus Immaturus total flavonoids (AFIF) is the main effective fraction extracted from AFI, which has a good effect on promoting gastrointestinal motility. This study aimed to investigate AFIF which regulates miR-5100 to improve constipation symptoms in mice by targeting Frizzled-2 (Fzd2) to alleviate interstitial cells of Cajal (ICCs) calcium ion balance and autophagy apoptosis. The constipated mouse model was induced by an antibiotic suspension, and then treated with AFIF. RNA-seq sequencing, luciferase assay, immunofluorescence staining, transmission electron microscopy, ELISA, flow cytometry, quantitative polymerase chain reaction (PCR), and Western blot were applied in this study. The results showed that AFIF improved constipation symptoms in antibiotic-induced constipated mice, and decreased the autophagy-related protein Beclin1 levels and the LC3-II/I ratio in ICCs. miR-5100 and its target gene Fzd2 were screened as key miRNAs and regulator associated with autophagy. Downregulation of miR-5100 caused increased expression of Fzd2, decreased proliferation activity of ICCs, increased apoptotic cells, and enhanced calcium ion release and autophagy signals. After AFIF treatment, miR-5100 expression was upregulated and Fzd2 was downregulated, while autophagy-related protein levels and calcium ion concentration decreased. Furthermore, AFIF increased the levels of SP, 5-HT, and VIP, and increased the expression of PGP9.5, Sy, and Cx43, which alleviated constipation by improving the integrity of the enteric nervous system network. In conclusion, AFIF could attenuate constipation symptoms by upregulating the expression of miR-5100 and targeting inhibition of Fzd2, alleviating calcium overload and autophagic death of ICCs, regulating the content of neurotransmitters, and enhancing the integrity of the enteric nervous system network.

Efficacy of an internal teat sealant alone or in combination with an intramammary antibiotic during the dry period treatment in dairy cows

In this study, the aim was to determine the effectiveness of internal teat sealant applied at the dry-off in preventing the formation of subclinical mastitis and to investigate whether this product could be a non-antibiotic alternative to total dry cow treatment. A total of 195 quarters from 52 Holstein and Holstein Crossbreed dairy cows, that did not have clinical mammary infection and were expected to calve within 60 days were used in the study. The quarters were divided into 3 treatment groups as follows: Group 1 (ANTB; n = 64): dry period intramammary antibiotic suspension (Ubrostar®); Group 2 (ORB; n = 65), internal teat sealant (Orbeseal®); and Group 3 (ANTB-ORB; n = 66) intramammary antibiotic and teat sealant combination were performed. All of the quarters were checked for subclinical mastitis on the 20th, 40th and 60th days of lactation. The percentage of animals found to be CMT negative on the 20th day of lactation was 80.65% in G1 (ANTB), 83.60% in Group 2 (ORB), and 87.50% in Group 3 (ANTB-ORB), respectively. There was no quarter with CMT +3 score in G1 and G3, but it was determined in one quarter in G2 (ORB). On the 60th day there were no quarters with CMT +2 and +3 scores in both G1 and G2. No statistically significant difference was found between the CMT results of treatment groups on the 20th, 40th and 60th days of lactation (p &gt; 0.05). In conclusion, it was determined that bismuth subnitrate-based teat canal sealer provided good protection against subclinical mastitis rate in drying healthy udder quarters. However, especially in high risk groups it is important to closely monitor udder health with SCC and/or CMT applications before the dry period and to choose the dry period treatment.

Antibiotic Use for Patients with Inherited Metabolic Diseases in Outpatient Clinical Setting

Objective: In this study, we aimed to assess the the frequency and accuracy of antibiotic use for upper respiratory tract infection for children younger than 6 years of age with inherited metabolic diseases and also to identify possible associated factors in the outpatient clinic. Materials and Methods: This study was a prospective, randomized, single center study in which children with upper respiratory tract infections were enrolled. A 25-question questionnaire was prepared to ask the patients' families. These survey questions were included age, gender, weight, parental ages, education levels, type of antibiotics given, antibiotic dose and frequency. Results: Of the 415 individuals, 380 patients and caregivers agreed to participate in the study. The most prescribed antibiotics were amoxicillin/clavunate (31.57%), amoxicillin (21.31%) and clarithromycin (15.26%). We demonstrated that antibiotic dose was inappropriate in 42.89% of our patients. Of dosing errors, 37.4% involved dosing under the prescribed amount, while 62.6% involved dosing above the recommended amount. Conclusion: Healthcare professionals should routinely emphasize the importance of using accurate dose when administering antibiotic suspensions especially in the case of inborn errors metabolism in order to avoid inappropriate treatment, adverse effects and antibiotic resistence.

Excessive Dilution of Oral Antibiotic Suspensions and Oversized Bottles: An Exploratory Survey Based on Pediatrician’s Experiences in Kabul

Medication errors in the reconstitution of oral suspensions, which include excessive dilution, may affect the treatment outcome despite the correct diagnosis and selection of appropriate treatment. Objective: To document the practice of parents/caregivers adding more than double the recommended volume of water to oversized bottles of oral Azithromycin or Cefixime suspensions. Method: An exploratory survey was conducted using self-administered anonymous questionnaires. It involved the participation of 32 pediatricians from different pediatrics departments at Maiwand Teaching Hospital, an inner-city hospital in Kabul. The survey aimed to gather pediatricians' experiences with parents/caregivers adding excessive water to Azithromycin or Cefixime oral suspensions to approximately twice the recommended concentration Results: Twenty-five participating pediatricians (78.1%) reported encountering at least one instance where more than double the recommended amount of water was added to Azithromycin or Cefixime suspensions. The majority of these cases (84%) were observed in the outpatient department. Eighteen participants (72%) thought the issue was rare or infrequent, while seven (28%) thought it was frequent. Conclusion: Bottles of oversized oral antibiotic suspensions had been filled up with water to nearly their full volumes, which reduced the concentration of active substances to half or less, and may threaten the treatment outcome. This problem is not confined to any particular country but can arise in any situation where non-healthcare professionals reconstitute pediatric oral suspensions using oversized bottles. Improved reconstitution education, separate diluent bottles for oral suspension, and the establishment of standards and ceilings relative to total dose volume for oral suspension bottles are recommended.

Development of inhalation powders containing lactic acid bacteria with antimicrobial activity against Pseudomonas aeruginosa

The aim of the project was to develop and characterise powders containing a probiotic (Lactiplantibacillus plantarum [Lpb. plantarum], Lacticaseibacillus rhamnosus, or Lactobacillus acidophilus) to be administered to the lung for the containment of pathogen growth in patients with lung infections. The optimised spray drying process for the powder manufacturing was able to preserve viability of the bacteria, which decreased of only one log unit and was maintained up to 30 days. Probiotic powders showed a high respirability (42%-50% of particles had a size < 5 µm) suitable for lung deposition and were proven safe on A549 and Calu-3 cells up to a concentration of 107 colony-forming units/mL. The Lpb. plantarum adhesion to both cell lines tested was at least 10%. Surprisingly, Lpb. plantarum powder was bactericidal at a concentration of 106 colony-forming units/mL on P. aeruginosa, whereas the other two strains were bacteriostatic. This work represents a promising starting point to consider a probiotic inhalation powder a value in keeping the growth of pathogenic microflora in check during the antibiotic inhalation therapy suspension in cystic fibrosis treatment regimen. This approach could also be advantageous for interfering competitively with pathogenic bacteria and promoting the restoration of the healthy microbiota.

Tunable particle shells of thermo-responsive liquid marbles under alternating magnetic field

Liquid marbles, droplets entrapped in a solid particle shell at the air–liquid interface, can respond to stimuli such as alternating magnetic fields. In this study, we examined liquid marbles composed of the ferrofluid core covered by diverse particles, including thermo-responsive polymer microspheres. The temperature elevation induced by an alternating magnetic field provided the particle surface of the marbles with enhanced properties and broadened the functionality of the entire structure. The thermal response partially rigidified the particle shell, and despite temperature-induced evaporation of the liquid core, the residual shell could be easily refilled with an intended cargo, e.g., an additional portion of ferrofluid or an antibiotic suspension. Due to the presence of magnetic particles inside the droplets, liquid marbles were also responsive to static magnetic fields, enabling control over their position and spatial orientation using magnets. We also obtained patchy and Janus structures employing magneto-coalescence of two or more liquid marbles, underscoring the innovative use of alternating magnetic fields to modulate liquid marble properties potentially serving as delivery agents in various applications.

1309. Adherence to Short-Term Antibiotic Therapy in Children – a Blinded, Prospective, Electronically-Monitored Study

Abstract Background Non-adherence to short-term antibiotic treatment in children can lead to treatment failure and development of drug resistance. To develop effective interventional programs reliable adherence data is needed, but previous studies are scarce and have mostly used parental self-reports. We aimed to determine true adherence rates of pediatric patients treated for acute infections with antibiotic suspensions. Secondary goals were to evaluate patient and treatment characteristics influencing adherence rates and whether the prescriber can predict adherence rates of patients. Methods A prospective, blinded, electronically monitored, observational study. Patients aged 2 months to 5 years diagnosed with an acute bacterial infection requiring short (5-10 days) oral antibiotic monotherapy were enrolled. Parents were told they received a new "childproof" cap for evaluation, but unknowingly were provided with an electronically monitored medication bottle recording every manipulation of the cap. At the end of treatment study purpose was disclosed and, if approved, cap data and patient and treatment information collected. Results 100 infants (49 boys, mean [range] age 1.87 years [0.2-5.1]) were included in the final analysis. Only 11 participants received all the recommended doses. Overall adherence (defined as administration of &amp;gt;75% of prescribed doses) was 62%, while timing adherence (administration of &amp;gt;75% of doses within ±20% of the prescribed interval) was only 21%. After applying a logistic regression model, the only factor significantly associated with non-adherence was being a single parent [OR=5.7 95%CI (1.07-30.3)]. Prescribers overestimated adherence, defining 49/62 (77.7%) participants as likely adherent. Patient/parent pairs that were predicted to be adherent were not more likely to be overall or timing adherent than those predicted to be non-adherent (31/47 vs. 6/16, p=0.77). Conclusion Adherence of children to short-term antimicrobial treatment for an acute infection is suboptimal, with only 62% showing good adherence and 21% with good adherence at proper timing intervals. Providers were unable to predict patient adherence. This data is important when considering recommended treatment durations and developing interventional programs to increase adherence. Disclosures All Authors: No reported disclosures.

Stability studies of reconstituted oral amoxicillin suspension (125mg/5ml) under different temperature storage conditions

The research objective was to determine the physical stability and concentration of amoxicillin reconstituted oral suspension (125mg/5ml) stored under room temperature of 25°C and refrigeration temperature of 2-8°C days 1, 3, and 7. Three different brands of amoxicillin samples were used. Samples from the reconstituted amoxicillin suspension was assayed by HPLC to determine the concentration of the active and examined physically for taste, odour and colour change. The drug concentration for all three brands during the seven days ranged from 88.94 per cent - 102.17 per cent for refrigerated and 89.57-99.7 per cent for reconstituted amoxicillin at room temperature. The odour for days 1, 3 and 7 is fruity. The colour was pale yellow for days 1 and 3, while on day 7, it was creamy yellow. The taste was sweet on days 1 and 3, while on day 7, it was sweet/low bitter. The three brands maintained their potency and physical stability as required in the British pharmacopoeia. The reconstituted antibiotic suspensions must be stored at room temperature or in a refrigerator to maintain potency throughout their use. However, a good number of patients do not adhere to storage specifications resulting in the degradation of the product and subsequent loss of potency. The results for day one for all the drugs fall within the accepted range, drug K has its percent concentration the lowest, and microbiological studies should be done on this drug to ascertain microbial stability.

Evaluation of the Compatibility between Different Teat Sealants and Intramammary Antimicrobials in Selective Dry Cow Treatment Protocols

The dry period is a crucial time in the lactation cycle, it is the period of highest susceptibility to new infection and the optimum time to cure existing intramammary infection. In selective dry-cow antimicrobial therapy, we have two different ways of intervening in the management treatments of dry period: in the first case there are dairy cows diagnosed healthy, that will be treated only with the teat sealant, in the second, dairy cows with pathogenic mastitis or high cell counts that will receive the intramammary treatment together with the sealant. One of the main prerogative of an intramammary sealant is to ensure that it remains in the teat throughout the dry period. To guarantee this, it is necessary that the sealant is characterized by good rheological properties, especially when it is administered with an antimastitis ointment. The aim of the present study was to compare the rheological behavior of several intramammary sealant suspensions present on the Italian market. To evaluate the rheological behavior of the intramammary suspensions used during the dry period, rheological comparison methods have been developed. The parameters assessed during the rheological study are Viscosity, 3 Interval Thixotropy Test (3ITT) and the viscoelastic nature of materials: Amplitude Sweep. In addition, to evaluate the sealant performance of intramammary sealants, was performed a compatibility in-vitro test, comparing the behavior of the products alone and in contact with two intramammary antibiotic suspensions (Fatroximin and Mastout, both manufactured by Fatro S.p.A. and used during the dry period). The results obtained highlighted that, when a sealant has good viscosity and good thixotropic behavior, is more probable that it remains in the teat, carrying out its sealing action and preventing the entry of pathogens.

Antibiotic discontinuation through an antibiotic treatment optimization program in emergency department patients with low suspicion of infection

IntroductionOne of the most important strategies of PROA in the Emergency Department (ED) is the accurate diagnosis of infection to avoid inappropriate prescription. Our objective is to evaluate patients who receive antibiotics despite not having objective data of infection. MethodsWe carried out a cross-sectional study of patients admitted to the ED of the Hospital Universitario Fundación Alcorcón in which it was recommended to suspend the antibiotic through the PROA. Clinical and epidemiological characteristics and 30-day follow-up were analyzed to assess readmissions and mortality. Results145 patients were analyzed. It was recommended to suspend the antibiotic in 25. 44% of them had a diagnosis of urinary infection. The suspension recommendation was accepted by 88%. No patient died and one was readmitted. ConclusionsAn important percentage of patients are prescribed antibiotics despite not having infection criteria, the clinical evolution after suspension of antibiotics was favorable.

Suspensión de antibióticos a través de un programa de optimización de tratamiento antibiótico en pacientes atendidos en Urgencias con baja sospecha de infección

IntroductionOne of the most important strategies of PROA in the Emergency Department (ED) is the accurate diagnosis of infection to avoid inappropriate prescription. Our objective is to evaluate patients who receive antibiotics despite not having objective data of infection. MethodsWe carried out a cross-sectional study of patients admitted to the ED of the Hospital Universitario Fundación Alcorcón in which it was recommended to suspend the antibiotic through the PROA. Clinical and epidemiological characteristics and 30-day follow-up were analyzed to assess readmissions and mortality. Results145 patients were analyzed. It was recommended to suspend the antibiotic in 25. 44% of them had a diagnosis of urinary infection. The suspension recommendation was accepted by 88%. No patient died and one was readmitted. ConclusionsAn important percentage of patients are prescribed antibiotics despite not having infection criteria, the clinical evolution after suspension of antibiotics was favorable.

Taste Perceptions of Common Pediatric Antibiotic Suspensions and Associated Prescribing Patterns in Medical Residents.

Palatability of medication is an important factor for adherence, especially in pediatric populations that tend to use oral suspensions for antibiotic therapy. Our study is the first to evaluate the impact of taste on prescribing patterns of antibiotic suspensions. The objective was to determine if taste testing common antibiotic suspensions altered prescribing patterns of medical residents, through data extracted from the electronic health record. After assessing 5 "primer" tastes (sweet, salty, bitter, sour, umami [savory]), residents were randomized to sample 6 antibiotic suspensions to rate their taste perception. A 12-month retrospective and prospective analysis of outpatient prescribing practices of the residents followed, and the results were compared to the resident cohort randomized to no taste test. The 43 residents prescribed 207 liquid antibiotic prescriptions for 176 patients, with no difference in patient characteristics between residents in the taste test versus non-taste test group. Although amoxicillin was most preferable and amoxicillin-clavulanate least, the only significant finding was a greater prescribing rate of cefdinir among those who had tasted it and an inverse relationship between cephalexin taste preference and percentage prescribing amoxicillin in the taste group. Residents who tasted were poor in identifying primer tastes, but this did not impact prescribing patterns. Among 6 commonly prescribed antibiotic suspensions, amoxicillin remains a highly preferred taste among prescribers. Interestingly, after the taste test there was a significantly greater prescribing rate of cefdinir among those who had tasted it and somewhat lower prescribing rate for amoxicillin-clavulanate.

Children can be given oral solid dose antibiotics amid supply problems, NHS guidance says

Guidance from the Specialist Pharmacy Service has advised clinicians to encourage children “to swallow oral solid dose forms” of antibiotics where possible, instead of using oral suspensions. The guidance was published on 7 December 2022 following reports from pharmacists of worsening supply problems for antibiotic oral suspensions for children, including penicillin, amoxicillin and azithromycin. “Whole […]

High throughput in vitro characterization of pectins for pig(let) nutrition

BackgroundFiber-rich feed components possess prebiotic potential to enhance pig health and are considered a potential solution to the high prevalence of post-weaning diarrhea in pig production under the phased suspension of antibiotics and zinc oxide use.MethodsWe screened the gut microbiota modulatory properties of pectin substrates prepared from sugar beet within the freshly weaned piglet gut microbiome using an in vitro colon model, the CoMiniGut. We focused on testing a variety (13) of sugar beet-derived pectin substrates with defined structures, as well as known prebiotics such as inulin, fructooligosaccharide (FOS) and galactooligosaccharide (GOS), to gain insights on the structure–function related properties of specific substrates on the weaner gut microbial composition as well as shortchain fatty acid production (SCFA).ResultsSugar beet-derived pectin and rhamnogalacturonan-I selectively increased the relative abundance of Bacteroidetes, specifically Prevotella copri, Bacteroides ovatus, Bacteroides acidificiens, and an unclassified Bacteroides member. The degree of esterification impacted the relative abundance of these species and the SCFA production during the in vitro fermentations. Modified arabinans derived from sugar beet promoted the growth of Blautia, P. copri, Lachnospiraceae members and Limosilactobacillus mucosae and amongst all oligosaccharides tested yielded the highest amount of total SCFA produced after 24 h of fermentation. Sugar beet-derived substrates yielded higher total SCFA concentrations (especially acetic and propionic acid) relative to the known prebiotics inulin, FOS and GOS.ConclusionOur results indicate that the molecular structures of pectin, that can be prepared form just one plant source (sugar beet) can selectively stimulate different GM members, highlighting the potential of utilizing pectin substrates as targeted GM modulatory ingredients.

Minimizing the risk of Clostridium difficile infection as an early complication of autologous stem cell transplantation.

219 Background: Clostridium difficile infection (CDI) is one of the most important affecting patients immunocompromised by autologous stem cell transplantation (ASCT), and can be associated with increased morbidity and length of stay. One precipitating factor for index CDI cases in the ASCT population is heavy antibiotic exposure, which often includes prophylaxis. A retrospective review identified 11 cases of CDI (17%) in the 30-day period following ASCT performed at the University of Virginia Medical Center (UVAMC) between about June 2016 and July 2017. Various institutional and multicenter studies have reported incidence rates in this population ranging from less than 5% to more than 10%. Methods: To decrease CDI rate, a multidisciplinary team comprised of oncology and infectious diseases physicians, pharmacists, and nurses was formed. The group used quality improvement principles to identify and target areas of greatest significance. A first PDSA cycle was conducted between approximately July 2017 and June 2018, during which time administration of standard-of-care ciprofloxacin prophylaxis between T+0 and count recovery was suspended. A second PDSA cycle was executed between approximately May 2018 and July 2019, incorporating UV light equipment into existing post-discharge cleaning practices. Data were analyzed using process control charts with 3-sigma limits for ASCT length-of-stay (LOS) and 30-day post-transplant CDI incidence. Results: Suspension of prophylactic antibiotics did not have a significant effect on CDI incidence in our first PDSA cycle. In our second improvement cycle, most of which elapsed after prophylactic ciprofloxacin had been re-implemented, CDI incidence was almost halved, from 17 to 9%. A numerical decreased in LOS was observed in each subsequent PDSA cycle. Conclusions: Our multidisciplinary team applied quality improvement methods to drive a clinically significant reduction in the 30-day CDI incidence after ASCT at UVAMC. This outcome should be associated with an improved patient experience. Future PDSA cycles are scheduled and may include other cancer patients, beyond those receiving stem cell transplantation.[Table: see text]