The Relationship between Inpatient Fluoroquinolone Use and Clostridium difficile-Associated Diarrhea
| Autor: | Marilyn J Novell, Carol A. Morreale |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Clostridium difficile associated diarrhea medicine.drug_class Antibiotics Dysentery Young Adult Route of administration Levofloxacin Internal medicine Humans Medicine Pharmacology (medical) Antibiotic use Intensive care medicine Aged Retrospective Studies Aged 80 and over Cross Infection Clostridioides difficile business.industry Incidence Odds ratio Middle Aged Clostridium difficile bacterial infections and mycoses Anti-Bacterial Agents Diarrhea Case-Control Studies Clostridium Infections Female medicine.symptom business Fluoroquinolones medicine.drug |
| Zdroj: | Annals of Pharmacotherapy. 44:826-831 |
| ISSN: | 1542-6270 1060-0280 |
| DOI: | 10.1345/aph.1m696 |
| Popis: | BACKGROUND: Limited evidence suggests there may be a link between fluoroquinolone use and Clostridium difficile-associated diarrhea (CDAD), but such an association remains unclear due to conflicting data. OBJECTIVE: To determine the relationship between inpatient fluoroquinolone use and CDAD; secondary objectives included the relationship between CDAD and fluoroquinolone selection, duration of therapy, and route of administration, as well as the association between fluoroquinolones and CDAD complications. METHODS: We conducted a retrospective, case-control study of adult inpatients diagnosed with CDAD during the period of July 2007-July 2008. In total, 174 case patients were matched on a 1:1 basis with controls. A thorough assessment of all inpatient antibiotic use was conducted, including regimens administered at our institution within the previous 8 weeks. Odds ratios were calculated using univariate logistic-regression analysis. RESULTS: Use of fluoroquinolones was not significantly different between patients with CDAD and matching controls (OR 1.36; 95% CI 0.09 to 2.10; p = 0.16). No relationship was found between CDAD and the individual fluoroquinolones: ciprofloxacin (OR 1.36; 95% CI 0.87 to 2.12; p = 0.18), levofloxacin (OR 1.17; 95% CI 0.62 to 2.22; p = 0.63), and moxifloxacin (OR 1.34; 95% CI 0.81 to 2.20; p = 0.25). Fluoroquinolone route of administration did not differ significantly between groups for patients receiving intravenous (OR 1.20; 95% CI 0.74 to 1.94; p = 0.46) or oral (OR 0.79; 95% CI 0.44 to 1.44; p = 0.45) therapy. Complications from CDAD were not significantly increased by fluoroquinolone use (OR 1.37; 95% CI 0.72 to 2.61; p = 0.35). CONCLUSIONS: Inpatient administration of fluoroquinolones was not associated with CDAD at our institution. Fluoroquinolone use in patients who developed CDAD was not related to higher incidences of CDAD-related complications. |
| Databáze: | OpenAIRE |
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