Evidence map›Paper›PMID 37665427›Full record

ArticleDigestive diseases and sciences2023

First Clostridioides difficile Recurrence Is Highest Following Concomitant Antimicrobial Administration During and Within 30 Days of Treatment.

Abdelkader Chaar, John Damianos, Rabia Rizwan, Houssam Al-Nahhas, Muhammad Sohail Mansoor, Prabin Sharma, Umer Malik, Paul Feuerstadt

Abstract read
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In one paragraph

Article in Digestive diseases and sciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 48% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 1 country.

Abdelkader ChaarDepartment of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
John DamianosDepartment of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
Rabia RizwanDepartment of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
Houssam Al-NahhasSyria Public Health Network, London, UK.
Muhammad Sohail MansoorGI Specialists of Georgia, Marietta, GA, USA.
Prabin SharmaDepartment of Gastroenterology, Hartford Healthcare, St Vincent's Medical Center, Bridgeport, CT, USA.
Umer MalikDivision of Gastroenterology, Albany Medical Center, Albany, NY, USA.
Paul FeuerstadtSection of Digestive Diseases, Yale School of Medicine, New Haven, CT, USA. pfeuerstadt@gastrocenter.org.ORCID 0000-0002-7643-9576
Yale New Haven Hospital · USYale University · USAlbany Medical Center Hospital · USGI Specialists of Georgia (United States) · USSt. Vincent's Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClostridioides difficile infection (CDI) is an epidemic with the strongest risk factor being antibiotic usage. Patients who get CDI frequently require concomitant antibiotics for other indications around the time of their infection.

aimsTo assess the recurrence of CDI (rCDI) in patients receiving concomitant antibiotics at the same time or shortly thereafter treatment of CDI.

methodsWe retrospectively reviewed records for patients with their first inpatient CDI episode. Patients were grouped into those who didn't receive concomitant antibiotics (noABx), those receiving antibiotics at the same time as treatment of CDI (ABxDURING), those receiving antibiotics within 30-days of completion of CDI therapy (ABxAFTER) and those who received antibiotics both during and after CDI treatment (ABxDuringAfter). Our primary outcome was recurrence within 14-90 days; other outcomes included ICU stay at the time of diagnosis, 30-day ICU transfer, 30-day colectomy, and readmission.

results457 patients had CDI during admission (mean age: 66.4 years, 51.9% female). 64.1% were exposed to concomitant antibiotics. Recurrence rates were 4.3%, 6.1%, 13.8% and 19.1%, for noABx, ABxDURING, ABxAFTER and ABxDuringAfter, respectively. Patients with ABxDuringAfter had the highest rates of rCDI when compared to noABx [OR 5.67, 95% CI (2.18-14.72)].

conclusionsThere is a high rate of utilization of non-CDI antibiotics during or shortly after completing CDI treatment with high rates of recurrence within 90-days. Concomitant antimicrobials alter the opportunity for the microbiota to re-grow and worsens dysbiosis leading to increases in recurrence. Concomitant antimicrobial stewardship remains important in patients being treated for CDI and shortly after treatment.

Indexed as

Anti-Bacterial AgentsClostridioides difficileClostridium InfectionsAgedAged, 80 and overFemaleHumansMaleMiddle AgedPatient ReadmissionRecurrenceRetrospective StudiesRisk FactorsTime FactorsAnti-Bacterial AgentsAntibioticsC diffClostridioides difficileRecurrence

Identifiers

PMID37665427
OpenAlexW4386407523

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.