Abstract
BackgroundClostridioides difficile infection (CDI) is a common hospital-associated diarrhea. Several antibiotics commonly associate with CDI; however, limited data are available on the duration of exposure prior to CDI development. Moreover, studies on the characteristics of CDI patients in Saudi Arabia are limited. Therefore, the objective of this study was to characterize CDI patients identified over 10 years and assess antibiotic days of therapy (DOT) prior to CDI.MethodsThis was a retrospective descriptive analysis of CDI patients identified via laboratory testing at a Saudi tertiary academic medical center between December 2007-January 2018. Patients characteristics, prior exposure to known CDI risk factors, and DOT of antibiotics prior to CDI incidence were assessed.ResultsA total of 162 patients were included. Median age was 61.5 years. Most cases were hospital-acquired (70.4%) and admitted to general medical wards (81.5%). Prior exposure to antibiotics and acid suppression therapy were reported with the majority (75.9 and 75.3%, respectively). The most frequently prescribed antibiotics were piperacillin/tazobactam, ceftriaxone, meropenem, and ciprofloxacin with median DOTs prior to CDI incidence of 16.5, 16, 16, and 28 days, respectively. The distribution of DOT was significantly different for piperacillin/tazobactam, ceftriaxone, and ciprofloxacin in different units (P < 0.05). Counterintuitively, patients in non-ICU wards had the shortest antibiotic exposure prior to CDI development.ConclusionAs CDI is a common hospital-acquired infection resulting mainly from antibiotic exposure, results from this study indicate the need to revise antibiotic therapy to assess necessity and discontinue it when deemed unnecessary within the first two weeks.
Incidence of Clostridioides difficile infection at a Saudi Tertiary Academic Medical Center and compliance with IDSA/SHEA, ACG, and ESCMID guidelines for treatment over a 10-year period
