Antibiotics do not affect C difficile risk

Canadian research finds half of community-acquired cases are not related to antibiotic use.

Antibiotic prescribing does not increase the risk of Clostridium difficile infection, Canadian research suggests.

The findings contradict previous studies, which concluded that antibiotic use is to blame for the rise in cases of C difficile.

GPs have been advised to limit their prescribing of antibiotics, with recent NICE guidance recommending delayed antibiotic prescribing.

For this latest study, researchers analysed data on all hospital admissions for C difficile infection over an eight-year period.

They identified 836 patients, aged 65 and over who developed C difficile infection in the community and had been hospitalised for the infection.

Patients with hospital-acquired C difficile infections were excluded from the study because of the increased risk of infection in hospital.

Medical records were then analysed to identify whether patients had taken antibiotics and for how long.

Overall, they found that 53 per cent of patients had not been exposed to antibiotics during the 45 days preceding their C difficile-related hospitalisation.

This rate decreased to 46 per cent when the timeframe was extended to 90 days preceding hospital admission.

Lead researcher Dr Sandra Dial, from the Montreal Chest Institute of the McGill University Health Centre, said that the figures showed that half of community-acquired C difficile infections are not related to antibiotic use.

'While antibiotic use indeed plays an important role, other factors are likely to also be important,' she said.

'But we still need to determine what these other risk factors are.'

Testing for C difficile is mainly done on patients who have taken antibiotics, which probably means that not everyone is receiving a correct diagnosis, warned Dr Dial.

sanjay.tanday@haymarket.com

CMAJ 2008; 179: 767-72.

Comment below and tell us what you think

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

COVID-19 death rate highest among BAME groups, delayed PHE review confirms

COVID-19 death rate highest among BAME groups, delayed PHE review confirms

Death rates from COVID-19 are highest among patients from BAME groups, according...

GPs face hundreds of complaints over shielding and PPE during pandemic

GPs face hundreds of complaints over shielding and PPE during pandemic

GP practices have faced hundreds of complaints over issues including shielding and...

More than 3,600 GP partners lost in four years as decline accelerates

More than 3,600 GP partners lost in four years as decline accelerates

The number of full-time equivalent (FTE) GP partners in England fell by 3,636 between...

COVID-19 pandemic leaves 2.4m patients stuck in cancer care backlog

COVID-19 pandemic leaves 2.4m patients stuck in cancer care backlog

Around 2.4m patients are waiting longer for cancer tests or treatment because of...

PHE report delayed on how ethnicity affects COVID-19 outcomes

PHE report delayed on how ethnicity affects COVID-19 outcomes

Public Health England (PHE) has missed its 31 May deadline for reporting on how factors...

Lockdown complacency threatens second COVID-19 spike that could 'overwhelm' NHS

Lockdown complacency threatens second COVID-19 spike that could 'overwhelm' NHS

Complacency around easing coronavirus lockdown measures could trigger a second wave...