Metronidazole in the prevention of antibiotic-associated diarrhoea and Clostridium difficile infection in high-risk hospitalised patients

2018 ◽  
Vol 41 (6) ◽  
pp. 362-368
Author(s):  
Marco Tobar-Marcillo ◽  
Maria Guerrero-Duran ◽  
Ariana Avecillas-Segovia ◽  
Lillana Pacchiano-Aleman ◽  
Roberto Basante-Díaz ◽  
...  
Keyword(s):  
High Risk ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Hospitalised Patients ◽  
Antibiotic Associated Diarrhoea

scholarly journals Clostridium difficile Infection Epidemiology over a Period of 8 Years—A Single Centre Study

2020 ◽  
Vol 12 (11) ◽  
pp. 4439 ◽  
Author(s):  
Nicoleta Negrut ◽  
Delia Carmen Nistor-Cseppento ◽  
Shamim Ahmad Khan ◽  
Carmen Pantis ◽  
Teodor Andrei Maghiar ◽  
...  
Keyword(s):  
Public Health ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Healthcare Services ◽  
Common Infectious Disease ◽  
Single Centre Study ◽  
Significant Public Health ◽  
The Mean ◽  
North Western ◽  
Antibiotic Associated Diarrhoea

Clostridium difficile infection (CDI) is the most common infectious disease related to antibiotic-associated diarrhoea and is a current leading cause of morbidity/mortality, with substantial consequences for healthcare services and overall public health. Thus, we performed a retrospective epidemiological study of CDI for a long period (8 years), in an infectious hospital located in north-western Romania, which serves an entire county of the country (617,827 inhabitants). From 2011 to 2018, 877 patients were diagnosed with CDI; the mean incidence of this disease was 2.76 cases/10,000 patient-days, with an increasing trend in the annual incidence until 2016, at which point there was a decrease. The most commonly afflicted were patients in the 75–84 age group, observed in winter and spring. The results show that the antibiotics were administered in 679 (77.42%) subjects, within the last 3 months before CDI, statistically significant more than proton-pump inhibitors (PPIs)—128 (14.60%) and antidepressant medications—60 (6.84%), which were administered during the same period (p < 0.001). No medication was reported in 10 (6.84%) cases of CDI, in the last 3 months of the study. The fatality rate attained 4.1%, tripling in 2018 vs. 2011. CDI became a significant public health conundrum that can, nevertheless, be combatted through a judicious use of antibiotics.

scholarly journals Reducing risk of Clostridium difficile infection and overall use of antibiotic in the outpatient treatment of urinary tract infection

2018 ◽  
Vol 10 (10) ◽  
pp. 283-293 ◽  
Author(s):  
Ivy Y. Ge ◽  
Helene B. Fevrier ◽  
Carol Conell ◽  
Malika N. Kheraj ◽  
Alexander C. Flint ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
High Risk ◽  
Clostridium Difficile ◽  
Tract Infection ◽  
Antibiotic Treatment ◽  
Clostridium Difficile Infection ◽  
Case Control ◽  
Low Risk ◽  
Moderate Risk

Background: Risk of community-acquired Clostridium difficile infection (CA-CDI) following antibiotic treatment specifically for urinary tract infection (UTI) has not been evaluated. Methods: We conducted a nested case-control study at Kaiser Permanente Northern California, 2007–2010, to assess antibiotic prescribing and other factors in relation to risk of CA-CDI in outpatients with uncomplicated UTI. Cases were diagnosed with CA-CDI within 90 days of antibiotic use. We used matched controls and confirmed case-control eligibility through chart review. Antibiotics were classified as ciprofloxacin (most common), or low risk (nitrofurantoin, sulfamethoxazole/trimethoprim), moderate risk, or high risk (e.g. cefpodoxime, ceftriaxone, clindamycin) for CDI. We computed the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the relationship of antibiotic treatment for uncomplicated UTI and history of relevant gastrointestinal comorbidity (including gastrointestinal diagnoses, procedures, and gastric acid suppression treatment) with risk of CA-CDI using logistic regression analysis. Results: Despite the large population, only 68 cases were confirmed with CA-CDI for comparison with 112 controls. Female sex [81% of controls, adjusted odds ratio (OR) 6.3, CI 1.7–24), past gastrointestinal comorbidity (prevalence 39%, OR 2.3, CI 1.1–4.8), and nongastrointestinal comorbidity (prevalence 6%, OR 2.8, CI 1.4–5.6) were associated with increased CA-CDI risk. Compared with low-risk antibiotic, the adjusted ORs for antibiotic groups were as follows: ciprofloxacin, 2.7 (CI 1.0–7.2); moderate-risk antibiotics, 3.6 (CI 1.2–11); and high-risk antibiotics, 11.2 (CI 2.4–52). Conclusions: Lower-risk antibiotics should be used for UTI whenever possible, particularly in patients with a gastrointestinal comorbidity. However, UTI can be managed through alternative approaches. Research into the primary prevention of UTI is urgently needed.

scholarly journals Impact of an automatic hospital probiotic protocol on Clostridioides (Clostridium) difficile infection (CDI) rates and CDI antibiotic usage in a community hospital setting

2019 ◽  
Vol 21 (2) ◽  
pp. 72-75
Author(s):  
Douglas Slain ◽  
Amy Georgulis ◽  
Ron Dermitt ◽  
Laura Morris ◽  
Stephen M Colodny
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Community Hospital ◽  
Hospital Setting ◽  
Saccharomyces Boulardii ◽  
Antibiotic Usage ◽  
Oral Vancomycin ◽  
Hospitalised Patients ◽  
Oral Metronidazole

The aim of the present study was to see how widespread preventative use of the probiotic Saccharomyces boulardii via automatic protocol in hospitalised patients receiving antibacterials affected rates of hospital-associated Clostridioides ( Clostridium) difficile infection (HA-CDI). Rates of HA-CDI appeared to be similar between the pre-protocol and protocol periods. Use of CDI treatment antibiotics (oral metronidazole and oral vancomycin) was also similar. Laboratory-confirmed isolation of S. boulardii from sterile body sites was identified in five patients during the protocol versus only one case in the pre-protocol years.

scholarly journals Increasing rates in Clostridium difficile infection (CDI) among hospitalised patients, Spain 1999-2007

2008 ◽  
Vol 13 (31) ◽  
Author(s):  
A Asensio ◽  
J Vaque-Rafart ◽  
F Calbo-Torrecillas ◽  
J J Gestal-Otero ◽  
F López-Fernández ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Binary File ◽  
Hospitalised Patients

Binary file ES_Abstracts_Final_ECDC.txt matches

Community-acquired Clostridium difficile infection and Australian food animals

2015 ◽  
Vol 36 (3) ◽  
pp. 111 ◽  
Author(s):  
Michele M Squire ◽  
Daniel R Knight ◽  
Thomas V Riley
Keyword(s):  
High Risk ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Animal Husbandry ◽  
Gram Positive ◽  
Hospital Acquired Infection ◽  
Infectious Diarrhoea ◽  
Food Animal ◽  
Risk Practices ◽  
Hospital Acquired

Clostridium difficile is an anaerobic Gram positive spore-forming bacterium, the leading cause of infectious diarrhoea (C. difficile infection; CDI) in hospitalised humans. The assumption that CDI is primarily a hospital-acquired infection is being questioned. Community-acquired CDI (CA-CDI) is increasing1 particularly in groups previously considered at low risk2,3. In Australia, CA-CDI rates doubled during 2011 and increased by 24% between 2011 and 20124. Two potentially high-risk practices in Australian food animal husbandry may present a risk for CA-CDI: slaughtering of neonatal animals for food, and effluent recycling to agriculture.

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