Background and importance Suspicion of bacterial coinfection in patients with SARS-CoV-2 pneumonia has led to an increased consumption of antibiotics used in the treatment of community-acquired pneumonia (CAP). One of the best-known risk factors for Clostridioides difficile infection (CDI) development is antibiotic treatment but there are inconsistent findings regarding which groups of antibiotics are most strongly associated.
Aim and objectives We aimed to compare the risk of developing CDI during hospitalisation in the internal medicine division to changes in antibiotics consumption in the pre-pandemic and COVID-19 pandemic period.
Material and methods Single centre retrospective cohort study was conducted in a secondary hospital (900 beds). Hospitalised patients in the 2019 and 2020 periods who presented hospital-acquired diarrhoea with simultaneous C. difficile toxin determination were included. We selected patients admitted to internal medicine units to compare the incidence of CDI with the change in the antibiotic consumption profile between both periods.
Microbiological diagnosis consisted of simultaneous detection of glutamate dehydrogenase and toxins and enzyme immunoassay test. Positive results were confirmed by PCR.
Statistical treatment: to compare the CDI incidence between the two periods the rate ratio was calculated. Antibiotic consumption comparison was performed using independent samples Z-test.
Conclusion and relevance Changes in antimicrobial use related to the outbreak suggest that clinicians overprescribed first-line CAP-focused antibiotics.
CDI incidence reduction was related to a marked decreased use of quinolones and amoxicillin/clavulanic despite the fact that consumption of third-generation cephalosporins has doubled.
Another implemented protocol such as more comprehensive cleaning and hand-washing hygiene could have contributed to the marked CDI decrease.
Conflict of interest No conflict of interest
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.