Medical News Stories
Evaluating Contemporary Antibiotics as a Risk Factor for Clostridium Difficile Infection in Surgical Trauma Patients
Study Question: To identify whether specific antibiotics are associated with an increased risk of Clostridium difficile infection in hospitalized patients.
Study Description: This article describes a retrospective study where the case group had a positive C. difficile toxin assay at least 48 hours after admission and the control group did not. Patients between groups were matched for age and length of stay. If > 5% of case patients had been exposed to a particular antibiotic, then it was chosen for comparison.
Results: Sixty-seven patients had a positive C. difficile toxin assay, with trauma patients representing over half of both groups. Patients with prolonged exposure (defined as > 7 days) to cefepime, imipenem/cilastatin, and piperacillin/tazobactam were significantly more likely to develop CDI. Case patients more commonly received regimens consisting of 3 of more antibiotics and were exposed to 3 or more antibiotic classes.
Conclusion(s): Authors conclude these results may be used to help guide antimicrobial selection.
Perspective: This study’s results reaffirm the association between antibiotic exposure and the risk of developing CDI. Risk lies with broad-spectrum antibiotics in particular and the use of multiple antibiotic classes, reinforcing the importance of streamlining antimicrobial therapy outside of select indications such as polymicrobial infections and empiric therapy in patients with risk factors for infection with multi-drug resistant organisms.