ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2024
Influence of Antibiotic Exposure Intensity on the Risk of Clostridioides difficile Infection.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed.
- Gut microbiome dynamics in acute infectious diarrhea: A conceptual framework from acute dysbiosis toward precision restoration (Review).Experimental and therapeutic medicine · 2026Review
- Sustainability and Impact of an Antimicrobial Stewardship Program on Broad-Spectrum Antibiotic Consumption in South Korea: A 14-Month Extended Follow-Up Study.Antibiotics (Basel, Switzerland) · 2026Article
- The intestinal microbiota impacts nutritional immunity and resistance toProceedings of the National Academy of Sciences of the United States of America · 2026Article
- Large Language Model Recommendations for Empiric Antibiotics Versus Clinician Prescribing: A Non-Interventional Paired Retrospective Antimicrobial Stewardship Analysis.Antibiotics (Basel, Switzerland) · 2026Article
- Analysis of Antibiotic Consumption Trends and Pathogens' Epidemiological Profile Within a Multidisciplinary Clinical Hospital from Romania.Antibiotics (Basel, Switzerland) · 2026Article
- Early trajectories of antibiotic exposure and colonization pressure and risk of ICU-acquired carbapenem-resistant Gram-negative bacteria: A prospective cohort study.Annals of intensive care · 2026Article
- Regional Adherence to Early Sepsis Management Bundle and Associated Mortality in Hong Kong Between 2009-2018.Open forum infectious diseases · 2026Article
- Sexually transmitted enteric infections in men who have sex with men.Clinical microbiology reviews · 2025Review
- Spectrum, dose, and duration of antibiotic exposure and risk of intensive care unit-acquired carbapenem-resistant gram-negative bacteria: a prospective cohort study.Annals of intensive care · 2025Article
- Optimal antibiotic use in the intensive care unit.Critical care (London, England) · 2025Review
- Baicalin: Natural Sources, Extraction Techniques, and Therapeutic Applications Against Bacterial Infections.Molecules (Basel, Switzerland) · 2025Review
- Association Between Antimicrobials and Pump Proton Inhibitors Consumption with the Incidence of NosocomialAntibiotics (Basel, Switzerland) · 2025Article
- Low adherence to institutional clinical practice guideline in patients diagnosed withAntimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Repurposing thioridazine as a potential CD2068 inhibitor to mitigate antibiotic resistance inComputational and structural biotechnology journal · 2025Article
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9 authors.
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Abstract
backgroundAntibiotics are a strong risk factor for Clostridioides difficile infection (CDI), and CDI incidence is often measured as an important outcome metric for antimicrobial stewardship interventions aiming to reduce antibiotic use. However, risk of CDI from antibiotics varies by agent and dependent on the intensity (ie, spectrum and duration) of antibiotic therapy. Thus, the impact of stewardship interventions on CDI incidence is variable, and understanding this risk requires a more granular measure of intensity of therapy than traditionally used measures like days of therapy (DOT).
methodsWe performed a retrospective cohort study to measure the independent association between intensity of antibiotic therapy, as measured by the antibiotic spectrum index (ASI), and hospital-associated CDI (HA-CDI) at a large academic medical center between January 2018 and March 2020. We constructed a marginal Poisson regression model to generate adjusted relative risks for a unit increase in ASI per antibiotic day.
resultsWe included 35 457 inpatient encounters in our cohort. Sixty-eight percent of patients received at least 1 antibiotic. We identified 128 HA-CDI cases, which corresponds to an incidence rate of 4.1 cases per 10 000 patient-days. After adjusting for known confounders, each additional unit increase in ASI per antibiotic day was associated with 1.09 times the risk of HA-CDI (relative risk = 1.09; 95% CI: 1.06-1.13).
conclusionsThe ASI was strongly associated with HA-CDI and could be a useful tool in evaluating the impact of antibiotic stewardship on HA-CDI rates, providing more granular information than the more commonly used DOT.
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