Quasiexperimental study of the effects of antibiotic use, gastric acid-suppressive agents, and infection control practices on the incidence of Clostridium difficile-associated diarrhea in hospitalized patients
| Autor: | Nathalie Vernaz, James McElnay, Chris Funston, Mamoon A. Aldeyab, Stéphan Juergen Harbarth, Michael G. Scott, Denise Kelly, Karen Savage, M. P. Kearney, Motasem Abdelghani Mustafa Aldiab |
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| Rok vydání: | 2009 |
| Předmět: |
Diarrhea
medicine.medical_specialty Diarrhea/*epidemiology/microbiology Northern Ireland Internal medicine Epidemiology medicine Infection control Histamine H2 Antagonists/*therapeutic use Humans Pharmacology (medical) Intensive care medicine Hospitals Teaching Letters to the Editor Enterocolitis Pseudomembranous Antibacterial agent Aged Pharmacology ddc:616 Antiinfective agent Anti-Bacterial Agents/classification/*therapeutic use Northern Ireland/epidemiology Infection Control Infection Control/*methods business.industry Clostridioides difficile Incidence (epidemiology) Incidence Infant Newborn Infant Retrospective cohort study Clostridium difficile bacterial infections and mycoses Trimethoprim Anti-Bacterial Agents Infectious Diseases Histamine H2 Antagonists Child Preschool Hospitals Teaching/standards business Clostridium difficile/*drug effects medicine.drug Enterocolitis Pseudomembranous/*epidemiology/microbiology |
| Zdroj: | Antimicrobial Agents and Chemotherapy, Vol. 53, No 5 (2009) pp. 2082-2088 Aldeyab, M A, Harbarth, S, Vernaz, N, Kearney, M P, Scott, M G, Funston, C, Savage, K, Kelly, D, Aldiab, M A & McElnay, J C 2009, ' Quasiexperimental Study of the Effects of Antibiotic Use, Gastric Acid-Suppressive Agents, and Infection Control Practices on the Incidence of Clostridium difficile-Associated Diarrhea in Hospitalized Patients ', Antimicrobial Agents and Chemotherapy, vol. 53, no. 5, pp. 2082-2088 . https://doi.org/10.1128/AAC.01214-08 |
| ISSN: | 1098-6596 0066-4804 |
| DOI: | 10.1128/AAC.01214-08 |
| Popis: | The objective of this study was to evaluate the effects of antimicrobial drug use, gastric acid-suppressive agent use, and infection control practices on the incidence of Clostridium difficile -associated diarrhea (CDAD) in a 426-bed general teaching hospital in Northern Ireland. The study was retrospective and ecological in design. A multivariate autoregressive integrated moving average (time-series analysis) model was built to relate CDAD incidence with antibiotic use, gastric acid-suppressive agent use, and infection control practices within the hospital over a 5-year period (February 2002 to March 2007). The findings of this study showed that temporal variation in CDAD incidence followed temporal variations in expanded-spectrum cephalosporin use (average delay = 2 months; variation of CDAD incidence = 0.01/100 bed-days), broad-spectrum cephalosporin use (average delay = 2 months; variation of CDAD incidence = 0.02/100 bed-days), fluoroquinolone use (average delay = 3 months; variation of CDAD incidence = 0.004/100 bed-days), amoxicillin-clavulanic acid use (average delay = 1 month; variation of CDAD incidence = 0.002/100 bed-days), and macrolide use (average delay = 5 months; variation of CDAD incidence = 0.002/100 bed-days). Temporal relationships were also observed between CDAD incidence and use of histamine-2 receptor antagonists (H2RAs; average delay = 1 month; variation of CDAD incidence = 0.001/100 bed-days). The model explained 78% of the variance in the monthly incidence of CDAD. The findings of this study highlight a temporal relationship between certain classes of antibiotics, H2RAs, and CDAD incidence. The results of this research can help hospitals to set priorities for restricting the use of specific antibiotic classes, based on the size-effect of each class and the delay necessary to observe an effect. |
| Databáze: | OpenAIRE |
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