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Moxifloxacin Therapy as a Risk Factor for Clostridium difficile–Associated Disease During an Outbreak: Attempts to Control a New Epidemic Strain

  • Priscilla Biller (a1), Beth Shank (a1), Leah Lind (a2), Meghan Brennan (a3), Lisa Tkatch (a1), George Killgore (a3), Angela Thompson (a3) and L. Clifford McDonald (a3)...

An outbreak of Clostridium difficile-associated disease (CDAD) caused by the epidemic North American pulsed-field gel electrophoresis type 1 (NAP1) strain began after a formulary change from levofloxacin to moxifloxacin. Cases of CDAD were associated with moxifloxacin use, but a formulary change back to levofloxacin failed to reduce rates of disease. Substituting use of one fluoroquinolone with use of another without also controlling the overall use of drugs from this class is unlikely to control outbreaks caused by the NAP1 strain of C. difficile.

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Centers for Disease Control and Prevention, 1600 Clifton Road, MS A35, Atlanta, GA 30333 (
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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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