SynthesisAntimicrobial agents and chemotherapy2013
Meta-analysis of antibiotics and the risk of community-associated Clostridium difficile infection.
Synthesis in Antimicrobial agents and chemotherapy, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06127160 (Personalized Antibiotic Treatment in the Emergency Department), which is not on this map. Cited by 264 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Personalized Antibiotic Treatment in the Emergency Department: Panther Trial
Who cites it
264 citing papers in PubMed, 5 syntheses or guidelines pooled it, 576 citations in OpenAlex.
- The role of oral amoxicillin/clavulanic acid in the treatment of osteomyelitis: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Pooled it
- Omadacycline andThe Annals of pharmacotherapy · 2023Pooled it
- Pooled it
- Antimicrobial treatment of Erysipelatoclostridium ramosum invasive infections: a systematic review.Revista do Instituto de Medicina Tropical de Sao Paulo · 2021Pooled it
- Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children.Intensive care medicine · 2020Guideline
- Oral β-Lactams, Fluoroquinolones, or Trimethoprim-Sulfamethoxazole for Definitive Treatment of UncomplicatedOpen forum infectious diseases · 2024Trial
- Multiple-Ascending-Dose Phase 1 Clinical Study of the Safety, Tolerability, and Pharmacokinetics of CRS3123, a Narrow-Spectrum Agent with Minimal Disruption of Normal Gut Microbiota.Antimicrobial agents and chemotherapy · 2019Trial
- PHAGE Study: Effects of Supplemental Bacteriophage Intake on Inflammation and Gut Microbiota in Healthy Adults.Nutrients · 2019Trial
- Article
- Article
- Clinical Experience with Omadacycline for the Treatment of Diabetic Foot Infections and Acute Osteomyelitis.Infectious diseases and therapy · 2026Article
- Balancing act of cytokines in controlling the severity ofInfection and immunity · 2026Review
- Burden of Clostridioides difficile infection in China, 1990-2021: an analysis based on the global burden of disease study 2021.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Comparison ofGastroenterology research · 2026Article
- Bacterial Infection in Ebola Virus Disease, Marburg Virus Disease, Crimean-Congo Hemorrhagic Fever, and Lassa Fever.Open forum infectious diseases · 2026Review
- Antibiotic Class-Specific Effects on Inflammatory Bowel Disease: Microbiome Disruption, Risk, and Recovery.International journal of molecular sciences · 2026Review
- Evaluating the Cost Effectiveness of Rapid Diagnostic Testing for the Identification of Pathogens and Resistance Genes in Bloodstream Infections.PharmacoEconomics · 2026Article
- Sustained Improvement in Antibiotic Prescribing Among Private Practice Dentists Following Antibiotic Stewardship Education and Dashboard Implementation.Open forum infectious diseases · 2026Article
- Predictors of RecurrentDiagnostics (Basel, Switzerland) · 2026Article
- The Clinical Impact of Antibiotic Allergy Labels on One-Year Outcomes of Solid Organ Transplant Recipients.Clinical transplantation · 2026Article
204 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
The rising incidence of Clostridium difficile infection (CDI) could be reduced by lowering exposure to high-risk antibiotics. The objective of this study was to determine the association between antibiotic class and the risk of CDI in the community setting. The EMBASE and PubMed databases were queried without restriction to time period or language. Comparative observational studies and randomized controlled trials (RCTs) considering the impact of exposure to antibiotics on CDI risk among nonhospitalized populations were considered. We estimated pooled odds ratios (OR) for antibiotic classes using random-effect meta-analysis. Our search criteria identified 465 articles, of which 7 met inclusion criteria; all were observational studies. Five studies considered antibiotic risk relative to no antibiotic exposure: clindamycin (OR = 16.80; 95% confidence interval [95% CI], 7.48 to 37.76), fluoroquinolones (OR = 5.50; 95% CI, 4.26 to 7.11), and cephalosporins, monobactams, and carbapenems (CMCs) (OR = 5.68; 95% CI, 2.12 to 15.23) had the largest effects, while macrolides (OR = 2.65; 95% CI, 1.92 to 3.64), sulfonamides and trimethoprim (OR = 1.81; 95% CI, 1.34 to 2.43), and penicillins (OR = 2.71; 95% CI, 1.75 to 4.21) had lower associations with CDI. We noted no effect of tetracyclines on CDI risk (OR = 0.92; 95% CI, 0.61 to 1.40). In the community setting, there is substantial variation in the risk of CDI associated with different antimicrobial classes. Avoidance of high-risk antibiotics (such as clindamycin, CMCs, and fluoroquinolones) in favor of lower-risk antibiotics (such as penicillins, macrolides, and tetracyclines) may help reduce the incidence of CDI.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.