期刊
JOURNAL OF INFECTION
卷 73, 期 1, 页码 45-53出版社
W B SAUNDERS CO LTD
DOI: 10.1016/j.jinf.2016.04.008
关键词
Antibiotics; Healthcare-associated infections; Clostridium difficile; Macrolides; Pneumonia
资金
- Basilea Pharmaceutica International Ltd (Basel, Switzerland)
Objectives: Clostridium difficile infection (CDI) is strongly associated with anti-biotic treatment, and community-acquired pneumonia (CAP) is the leading indication for anti-biotic prescription in hospitals. This study assessed the incidence of and risk factors for CDI in a cohort of patients hospitalized with CAP. Methods: We analysed data from a prospective, observational cohort of patients with CAP in Edinburgh, UK. Patients with diarrhoea were systematically screened for CDI, and risk factors were determined through time-dependent survival analysis. Results: Overall, 1883 patients with CAP were included, 365 developed diarrhoea and 61 had laboratory-confirmed CDI. The risk factors for CDI were: age (hazard ratio [HR], 1.06 per year; 95% confidence interval [CI], 1.03-1.08), total number of antibiotic classes received (HR, 3.01 per class; 95% CI, 2.32-3.91), duration of antibiotic therapy (HR, 1.09 per day; 95% CI, 1.00-1.19 and hospitalization status (HR, 13.1; 95% CI, 6.0-28.7). Antibiotic class was not an independent predictor of CDI when adjusted for these risk factors (P > 0.05 by interaction testing). Conclusions: These data suggest that reducing the overall antibiotic burden, duration of antibiotic treatment and duration of hospital stay may reduce the incidence of CDI in patients with CAP. (C) 2016 The Authors. Published by Elsevier Ltd on behalf of The British Infection Association.
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