Izvorni znanstveni članak

Antibiotic-associated diarrhea and Clostridium difficile-associated disease: an observational retrospective study at the University Hospital for Infectious Diseases "Dr. Fran Mihaljević" in Zagreb

Rok Čivljak orcid.org/0000-0001-8766-7438 ; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Suzana Bukovski ; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Ivan Bambir orcid.org/0000-0002-1257-1092 ; Klinički bolnički centar Zagreb, Zagreb, Hrvatska
Mirjana Stanić ; Klinička bolnica Merkur, Zagreb, Hrvatska
Luka Torić ; Klinička bolnica Dubrava, Zagreb, Hrvatska
Slavica Sović ; Škola narodnog zdravlja "Dr. Andrija Štampar", Zagreb, Hrvatska
Mirjana Dumančić ; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Elvira Čeljuska Tošev ; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska

Sažetak

Antibiotic-associated diarrhea (AAD) is a complication related to the use of antibiotics. The incidence of AAD varies, depending on the type of antibiotic and risk factors, between 5–25%. Clostridium difficile (C. difficile) is the most common cause of AAD. The aim of the study was to determine epidemiological and clinical characteristics of AAD and Clostridium difficile-associated disease among adult patients hospitalized at the University Hospital for Infectious Diseases in Zagreb. Medical charts of patients hospitalized between January 1, 2012 and June 31, 2013 were retrospectively analyzed. Out of 217 patients with AAD, C. difficile was confirmed in 161 (74%) cases. Median age of patients was 72 years (range 23–93 years); 105 (48%) were male. At least one of the risk factors for development of AAD was present in 212 (98%) patients, with the most frequent being: older age (≥60 years) in 164 (76%), hospitalization in the past 30 days before onset of AAD in 153 (71%), previous immunosuppressive treatment in 28 (13%) patients. The most frequent antibiotics associated with AAD were: penicillins in 63 (29%), cephalosporins in 56 (26%), metronidazole in 40 (18%), and quinolones in 38 (17%) patients. The most frequent reasons for antibiotic treatment were: urinary tract infection in 65 (30%), respiratory tract infection in 48 (22%), and gastrointestinal infection in 25 (12%) cases. At admission, leukocytosis was registered in 128 (80%) patients; median WBC count was 13,3×109/L (range 4–71×109/L); median CRP was 66,9 mg/L (range 0,4–391 mg/L). Median disease duration was 11 (range 1–67) days. Most of our patients were successfully cured with mortality rate of 4%, and recurrence rate of 7% during the 6-month follow-up period. Multiple regression model showed that both, duration of symptoms prior to hospitalization and CRP level at admission, were significant independent predictors of duration and outcome of the disease. There were no statistically significant differences in most relevant demographic, clinical and laboratory parameters among patients with and without confirmation of C. difficile. For the overall epidemiological and clinical conclusions related to antibiotic-associated diarrhea and Clostridium difficile-associated disease, patients with less severe diseases and ambulatory treatment should be included in future studies, too.

Ključne riječi

Antibiotics; antibiotic-associated diarrhea; Clostridium difficile; diarrhea; hospitalized adults; risk factors; clinical outcome

Hrčak ID:

138006

URI

https://hrcak.srce.hr/138006

Datum izdavanja:

30.9.2014.

Podaci na drugim jezicima: hrvatski

Posjeta: 5.028 *