期刊
OPEN FORUM INFECTIOUS DISEASES
卷 8, 期 10, 页码 -出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/ofid/ofab419
关键词
antibiotic; Clostridium difficile; corticosteroid; diarrhea; steroid
资金
- Society of Infectious Diseases Pharmacists (SIDP)
- National Institutes of Health (NIH) National Institute of Allergy and Infectious Diseases (NIAID) [U01AI124290-01]
The study demonstrated a 46% relative reduction in the odds of developing CDI in patients who received corticosteroids within the past 90 days. The results provide the best clinical evidence to further support mechanistic studies underlying this phenomenon.
Background. The pathogenesis of Clostridioides difficile infection (CDI) involves a significant host immune response. Generally, corticosteroids act by suppressing the host inflammatory response, and their anti-inflammatory effects are used to treat gastrointestinal disorders. Although previous investigations have demonstrated mixed results regarding the effect of corticosteroids on CDI, we hypothesized that the anti-inflammatory effect of corticosteroids would decrease the risk of CDI in hospitalized patients. Methods. This was a case-control study of hospitalized adults. The case population included patients diagnosed with primary CDI who received at least 1 dose of a high-risk antibiotic (cefepime, meropenem, or piperacillin-tazobactam) in the 90 days before CDI diagnosis. The control population included patients who received at least 1 dose of the same high-risk antibiotic but did not develop CDI in the 90 days following their first dose of antibiotic. The primary study outcome was the development of CDI based on receipt of corticosteroids. Results. The final study cohort consisted of 104 cases and 153 controls. Those who received corticosteroids had a lower odds of CDI after adjusting for age, proton pump inhibitor use, and antibiotic days of therapy (odds ratio, 0.54; 95% CI, 0.30-0.97; P = .04). We did not observe an association between corticosteroid dose or duration and CDI. Conclusions. We demonstrated a 46% relative reduction in the odds of developing CDI in patients who received corticosteroids in the past 90 days. We believe that our results provide the best clinical evidence to further support mechanistic studies underlying this phenomenon.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据