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Patients, antibiotics and Clostridioides difficile: When your best friend becomes your worst enemy
Department of Infectious Diseases, Skaraborg Hospital Skövde, Sweden ; Centre for Antibiotic Resistance Research (CARe), Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Sweden ; Skaraborgsinstitutet, Skövde, Sweden.
Department of Infectious Diseases, Skaraborg Hospital Skövde, Sweden ; Centre for Antibiotic Resistance Research (CARe), Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Centre for Research and Development, Skaraborg Hospital Skövde, Sweden. (Wellbeing in Long-term Health Problems (WeLHP))ORCID iD: 0000-0002-7400-6574
2025 (English)In: JAC - Antimicrobial Resistance, E-ISSN 2632-1823, Vol. 7, no 5, article id dlaf163Article in journal (Refereed) Published
Abstract [en]

Background and objectives: Patients with recurrent Clostridioides difficile infection (rCDI) suffer long after infection. However, knowledge is incomplete regarding their perceptions of in-hospital care, antibiotic treatment and the most common risk factors for rCDI. Valid information processes are crucial for enabling such patients to avoid the suboptimal use of healthcare services and gain health literacy, good health and quality of life. This study aims to explore rCDI patients' perceptions of the causes of rCDI, information processes and strategies for the future.

Methods: Ten interviews, conducted with rCDI patients based on open-ended questions, were analysed using qualitative content analysis.

Results: All the respondents identified antibiotic treatment as a trigger of rCDI, but they were unaware of other important factors. They also reported receiving inadequate information, often entirely absent or delivered by healthcare professionals under great pressure, together with other barriers that prevented successful information transmission. In addition to a lack of proper information, they described self-created barriers, some of which were severely counterproductive or even harmful, such as avoiding healthcare when they were ill or not collecting prescribed antibiotics due to fear.

Conclusions: The respondents were often left to seek information and develop explanatory models, strategies and behaviours for the future by themselves. We recommend more standardized and personalized patient information to support effective preventive behaviours and to foster a better understanding of one of the most important tools of modern medicine - antibiotics. 

Place, publisher, year, edition, pages
Oxford University Press, 2025. Vol. 7, no 5, article id dlaf163
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Nursing Rehabilitation Medicine
Research subject
Wellbeing in long-term health problems (WeLHP)
Identifiers
URN: urn:nbn:se:his:diva-25860DOI: 10.1093/jacamr/dlaf163ISI: 001574681200001PubMedID: 40980594Scopus ID: 2-s2.0-105016336645OAI: oai:DiVA.org:his-25860DiVA, id: diva2:2001413
Funder
Region Västra Götaland, VGSKAS-1013941Region Västra Götaland, Skaraborgsinstitutet 20/1021
Note

CC BY 4.0

© 2025 The Author(s). Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy

Correspondence Address: J. Karp; Department of Infectious Diseases, Skaraborg Hospital, Skövde, Lövängsvägen, 451 42, Sweden; email: Johan.karp@gu.se

These findings were presented orally and on a poster for the Swedish meeting regarding infectious diseases and clinical microbiology in Örebro, May 2025.

This work was supported by the Unit of Research and Development, Skaraborgs Hospital, Skövde, Sweden (grant number VGSKAS-1013941) and Skaraborgsinstitutet, Skövde, Sweden (grant number 20/1021).

Available from: 2025-09-26 Created: 2025-09-26 Last updated: 2026-06-30Bibliographically approved

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Sundberg, Fredrika

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