ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Antibiotic Prescribing Choices and Their Comparative C. Difficile Infection Risks: A Longitudinal Case-Cohort Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 2 of them syntheses that pooled it.
What it found
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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.
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Who cites it
57 citing papers in PubMed, 2 syntheses or guidelines pooled it, 96 citations in OpenAlex.
- Pooled it
- Burden of Clostridioides difficile infection (CDI) - a systematic review of the epidemiology of primary and recurrent CDI.BMC infectious diseases · 2021Pooled it
- Delabeling penicillin allergies in plastic and reconstructive surgery: Cefazolin as the cornerstone for antibiotic prophylaxis.JPRAS open · 2026Review
- Antibiotic treatment of acute otitis media: has watchful waiting gone with the diagnosis?CJEM · 2026Article
- Restoring Microbial Balance: Clinical Applications, Challenges, and Future Directions of Fecal Microbiota Transplantation in Pediatric Disorders.Microorganisms · 2026Review
- Real-world use of eravacycline for the treatment of mono- and polymicrobial infections involving Enterobacterales.Microbiology spectrum · 2026Article
- Article
- Derivation and validation of a prediction model for primary and recurrentAntimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Changes in the Epidemiology of Clostridioides difficile Infection.Infectious disease clinics of North America · 2025Review
- Clinical burden of Clostridioides difficile infection in infective endocarditis: a single-center experience.Internal and emergency medicine · 2025Article
- Risk Factors and Outcomes of Clostridioides difficile Infection in Respiratory Intensive Care Unit Patients.The clinical respiratory journal · 2025Article
- Investigating the relationship between Helicobacter pylori and intestinal Clostridioides difficile infection: evidence from a cross-sectional study.BMC gastroenterology · 2025Article
- Article
- Guiding Clostridioides difficile Infection Prevention Efforts in a Hospital Setting With AI.JAMA network open · 2025Article
- Article
- Article
- Association Between Antimicrobials and Pump Proton Inhibitors Consumption with the Incidence of NosocomialAntibiotics (Basel, Switzerland) · 2025Article
- Risk Factors forAntibiotics (Basel, Switzerland) · 2025Article
- Influence of Antibiotic Exposure Intensity on the Risk of Clostridioides difficile Infection.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Guidelines to practice in hospitals at home: safe and effective continuous infusion pumps substantially increased penicillin use in erysipelas treatment.European journal of public health · 2024Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAntibiotic use is the strongest modifiable risk factor for the development of Clostridioides difficile infection, but prescribers lack quantitative information on comparative risks of specific antibiotic courses. Our objective was to estimate risks of C. difficile infection associated with receipt of specific antibiotic courses.
methodsWe conducted a longitudinal case-cohort analysis representing over 90% of Ontario nursing home residents, between 2012 and 2017. Our primary exposure was days of antibiotic receipt in the prior 90 days. Adjustment covariates included: age, sex, prior emergency department or acute care stay, Charlson comorbidity index, prior C. difficile infection, acid suppressant use, device use, and functional status. We examined incident C. difficile infection, including cases identified within the nursing home, and those identified during subsequent hospital admissions. Adjusted and unadjusted regression models were used to measure risk associated with 5- to 14-day courses of 18 different antibiotics.
resultsWe identified 1708 cases of C. difficile infection (1.27 per 100 000 resident-days). Longer antibiotic duration was associated with increased risk: 10- and 14-day courses incurred 12% (adjusted relative risk [ARR] = 1.12, 95% confidence interval [CI]: 1.09, 1.14) and 27% (ARR = 1.27, 95% CI: 1.21,1.30) more risk compared to 7-day courses. Among 7-day courses with similar indications: moxifloxacin resulted in 121% more risk than amoxicillin (ARR = 2.21, 95% CI: 1.67, 3.08), ciprofloxacin engendered 89% more risk than nitrofurantoin (ARR = 1.89, 95% CI: 1.45, 2.68), and clindamycin resulted in 112% (ARR = 2.12, 95% CI: 1.32, 3.78) more risk than cloxacillin.
conclusionsC. difficile infection risk increases with antibiotic duration, and there are wide disparities in risks associated with antibiotic courses used for similar indications.
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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.