Antibiotic prophylaxis and the risk of C lostridium difficile -associated diarrhoea

Antibiotic prophylaxis and the risk of C lostridium difficile -associated diarrhoea

To test the hypothesis that extended antibiotic prophylaxis increases the risk of Clostridium difficile -associated diarrhoea (CDAD), we conducted a retrospective cohort study of 2641 patients under-going cardiovascular surgery. Main outcome measures were the duration of prophylaxis (48h) and the oc...

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Veröffentlicht in:The Journal of hospital infection 2001-06, Vol.48 (2), p.93-97
Hauptverfasser: Harbarth, S., Samore, M.H., Carmeli, Y.
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Sprache:eng
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antimicrobial prophylaxis
Clostridium difficile
Coronary bypass surgery
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container_title The Journal of hospital infection
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creator Harbarth, S.
Samore, M.H.
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description To test the hypothesis that extended antibiotic prophylaxis increases the risk of Clostridium difficile -associated diarrhoea (CDAD), we conducted a retrospective cohort study of 2641 patients under-going cardiovascular surgery. Main outcome measures were the duration of prophylaxis (48h) and the occurrence of CDAD. CDAD occurred in 31 patients (1.2%), who were significantly older (70±9 y vs. 66±10 y;P=0.03), received more therapeutic antibiotics (2.2±1.9 vs. 0.4±0.9;P=0.001) and had a longer postoperative hospital stay (26±19 d vs. 9±8 d;P
doi_str_mv 10.1053/jhin.2001.0951
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Main outcome measures were the duration of prophylaxis (&lt;48h vs. &gt;48h) and the occurrence of CDAD. CDAD occurred in 31 patients (1.2%), who were significantly older (70±9 y vs. 66±10 y;P=0.03), received more therapeutic antibiotics (2.2±1.9 vs. 0.4±0.9;P=0.001) and had a longer postoperative hospital stay (26±19 d vs. 9±8 d;P&lt;0.001) than non-cases. After adjusting for confounding, we did not observe an association between prolonged prophylaxis and CDAD [adjusted odds ratio (AOR), 0.8; CI, 0.4–1.8]. In contrast, three independent predictors were identified: increasing length of hospital stay (AOR per one-day-increment, 1.03; CI, 1.01–1.05), and treatment with third generation cephalosporins (AOR, 5.9; CI, 2.2–16.0) or β-lactam-β-lactamase inhibitor combinations (AOR, 4.6; CI, 1.7–12.3). 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subjects antimicrobial prophylaxis
Clostridium difficile
Coronary bypass surgery
title Antibiotic prophylaxis and the risk of C lostridium difficile -associated diarrhoea
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