Saludos cada vez tenemos mas casos de Clostridium difficile, adjunto archivo interesante
Summary and Comment
Cumulative Antibiotic Exposure Is Associated with Risk for C. difficile InfectionIn a retrospective study among hospitalized patients, higher cumulative dose, number, and duration of antibiotics were independently associated with greater risk.
Antibiotic therapy is a major risk factor for Clostridium difficile infection (CDI), but little is known about the effect of cumulative exposure. To explore this issue, researchers performed a retrospective cohort study involving adults who were hospitalized at a Rochester, New York, medical center in 2005 and received antibiotics for 2 consecutive days during their stay.
For each day of antibiotic exposure, the total dose of each agent was calculated. Daily doses were standardized according to the WHO Defined Daily Dose system. The number of different antibiotics and the duration of exposure were also calculated.
A total of 10,154 hospitalizations involving 7792 unique patients met study criteria. The incidence of CDI in this group was 4.3 per 10,000 patient-days. Factors significantly associated with increased CDI risk included older age, gastrointestinal procedures, HIV infection, history of CDI, higher chronic disease score, longer length of stay, and receipt of antacid therapy, including proton-pump or histamine-2 inhibitors. In addition, CDI risk rose, in a dose-dependent manner, with increases in cumulative dose, number, and days of antibiotics. Risk was 7.8-fold higher in patients with >18 antibiotic days than in those with <4 days and 9.6-fold higher in patients who received five or more antibiotics than in those who received only one. Intravenous cephalosporins, β-lactamase inhibitor combinations, sulfa drugs, fluoroquinolones, and vancomycin were all associated with an increased risk for CDI.
Comment: These findings suggest that longer durations of therapy and increasing numbers of antibiotics are associated with heightened risk for CDI. One surprising outcome is that vancomycin — a therapy for CDI when given orally — is a risk factor when administered intravenously.— Neil M. Ampel, MDPublished in Journal Watch Infectious Diseases July 13, 2011
Cumulative Antibiotic Exposure Is Associated with Risk for C. difficile InfectionIn a retrospective study among hospitalized patients, higher cumulative dose, number, and duration of antibiotics were independently associated with greater risk.
Antibiotic therapy is a major risk factor for Clostridium difficile infection (CDI), but little is known about the effect of cumulative exposure. To explore this issue, researchers performed a retrospective cohort study involving adults who were hospitalized at a Rochester, New York, medical center in 2005 and received antibiotics for 2 consecutive days during their stay.
For each day of antibiotic exposure, the total dose of each agent was calculated. Daily doses were standardized according to the WHO Defined Daily Dose system. The number of different antibiotics and the duration of exposure were also calculated.
A total of 10,154 hospitalizations involving 7792 unique patients met study criteria. The incidence of CDI in this group was 4.3 per 10,000 patient-days. Factors significantly associated with increased CDI risk included older age, gastrointestinal procedures, HIV infection, history of CDI, higher chronic disease score, longer length of stay, and receipt of antacid therapy, including proton-pump or histamine-2 inhibitors. In addition, CDI risk rose, in a dose-dependent manner, with increases in cumulative dose, number, and days of antibiotics. Risk was 7.8-fold higher in patients with >18 antibiotic days than in those with <4 days and 9.6-fold higher in patients who received five or more antibiotics than in those who received only one. Intravenous cephalosporins, β-lactamase inhibitor combinations, sulfa drugs, fluoroquinolones, and vancomycin were all associated with an increased risk for CDI.
Comment: These findings suggest that longer durations of therapy and increasing numbers of antibiotics are associated with heightened risk for CDI. One surprising outcome is that vancomycin — a therapy for CDI when given orally — is a risk factor when administered intravenously.— Neil M. Ampel, MDPublished in Journal Watch Infectious Diseases July 13, 2011
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