To understand physician's evolving practice patterns and knowledge of C.difficile infections, KeyOps teamed up with Dr. Jessica Allegretti in hopes of surveying 50 gastroenterologists about CDI testing and treatment. Within just one week, we had 111 GIs sign up and had to close the survey due to high demand.
Dr. Jessica Allegretti is the director of the fecal microbiota transplant program at Brigham and Women's Hospital, and is leading several clinical trials investigating the use of fecal transplantation in chronic diseases such as IBD and Primary Sclerosing Cholangitis.
Who: 103 US-based gastroenterologists
What: Diagnosis and treatment of C. difficile infections
How: Recruited over 100+ GIs within 1 week to a qualitative nationwide survey
- 81% of GIs see up to 5 CDI patients a month.
- 71% of physicians identified that GDH reflexed to EIA testing is the recommended testing modality to diagnose CDI
- 57% of physicians currently offer FMT as a treatment option
- 83% of GIs plan to use microbiome-based therapeutics once approved in lieu of FMT.
Below is a detailed summary of responses to individual questions as well as anonymous comments from the KeyOps community.
Thank you for your valuable insights!
81% of GIs see up to 5 CDI patients a month. How many times a month do they send C. difficile tests in their outpatient practice?
The majority send more than 2 tests per month
"C difficile is becoming an increasingly more common condition GIs see where as it previously was traditionally an ID condition"
— Dr. Jessica Allegretti
64% of physicians order 2 or more tests for CDI per month
The majority send more than 2 tests per month
What type of C. difficile testing is available at your center?
GDH reflexed to EIA toxin testing is the most commonly available test followed by PCR
"I think it's great the majority have GDH reflexed to EIA but notable that more that 50% still have PCR only testing, which can be problematic as it does not distinguish colonization from actual infection."
— Dr. Jessica Allegretti
Per the new ACG CDI Guidelines, what testing approach is recommended for the diagnosis of suspected CDI?
71% of physicians identified that GDH reflexed to EIA testing is the recommended testing modality to diagnose CDI
Great to see the vast majority read and recognize the guideline recommendations.
— Dr. Jessica Allegretti
57% of physicians offer FMT. Where do you obtain donor material for FMT currently?
Openbiome is the most frequently used source for donor material
"Only about half of GIs offer FMT currently, and almost all use Openbiome. This clearly reflects the decline in the ability to provide this therapy as a result of the pandemic."
— Dr. Jessica Allegretti
Why do you not offer FMT in your practice currently?
Most commonly cited reasons for not offering FMT is COVID related issues and lack of resources (for e.g. experience, personnel, facility)
"Lack of resources is also interesting – indicating there is a need for further training in this space"
— Dr. Jessica Allegretti
83% of GIs plan to use microbiome-based therapeutics once approved in lieu of FMT.
What benefits do you believe micro-biome based therapeutics have above FMT? Physicians believe microbiome-based therapeutics are more effective and easier to use.
"It's interesting that the majority thinks these new products will be more effective than FMT given the data we have already seen from more traditional FMT."
— Dr. Jessica Allegretti
17% of physicians do not intend to offer FMT
Most commonly cited reasons are the need to learn more and limited efficacy.
Respondent profile
103
US-based gastroenterologists
1 wk
To recruit 111+ physicians
