Antibiotic prophylaxis for surgical site infections as a risk factor for infection with Clostridium difficile

摘要: Objective We aimed to measure the association between 2013 guideline concordant prophylactic antibiotic use prior surgery and infection with Clostridium difficile. Design conducted a retrospective case-control study by selecting patients who underwent surgical procedure January 1, 2012 December 31, 2013. Setting Large urban community hospital. Patients Cases controls were age 18+ years an eligible (i.e., colorectal, neurosurgery, vascular/cardiac/thoracic, hysterectomy, abdominal/pelvic orthopedic procedures) within six months diagnosis. Cases diagnosed C. difficile while not. Methods The primary exposure was receiving (vs. not receiving) recommended regimen, based on type duration. Potential confounders included age, sex, length of hospital stay, comorbidities, surgery, use. Crude adjusted odds ratios (OR) 95% confidence intervals (CI) calculated using logistic regression. Results enrolled 68 cases 220 controls. The OR among developing regimen (usually antimicrobial prophylaxis for more than 24 hours) 6.7 (95% CI: 2.9–15.5). Independent risk factors having severe antibiotics previous 6 months, undergoing surgery. Conclusions Adherence likely reduces probability being case difficile. Antibiotic stewardship should be priority in strategies decrease morbidity, mortality, costs associated infection.