scholarly journals Torsade de pointes: A nested case–control study in an integrated healthcare delivery system

2021 ◽  
Author(s):  
Neha Mantri ◽  
Meng Lu ◽  
Jonathan G. Zaroff ◽  
Neil Risch ◽  
Thomas Hoffmann ◽  
...  
Keyword(s):  
Delivery System ◽  
Case Control Study ◽  
Healthcare Delivery ◽  
Torsade De Pointes ◽  
Case Control ◽  
Healthcare Delivery System ◽  
Integrated Healthcare ◽  
Nested Case Control ◽  
Control Study

Case-Control Study of Antibiotic Use and Subsequent Clostridium difficile–Associated Diarrhea in Hospitalized Patients

2008 ◽  
Vol 29 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Roger Baxter ◽  
G. Thomas Ray ◽  
Bruce H. Fireman
Keyword(s):  
Clostridium Difficile ◽  
Case Control Study ◽  
Gastrointestinal Disease ◽  
Healthcare Delivery ◽  
Case Control ◽  
Healthcare Delivery System ◽  
Retrospective Case ◽  
Increased Risk ◽  
And Control ◽  
Control Study

Objective.To determine which antibiotics increase or decrease the risk of Clostridium difficile-associated diarrhea (CDAD).Design.Retrospective case-control study.Setting.Nonprofit, integrated healthcare delivery system in Northern California.Patients.Study participants included patients with cases of hospital-acquired CDAD that occurred during the period from 1999 through 2005 (n = 1,142) and control patients (n = 3,351) matched for facility, calendar quarter during which hospitalization occurred, diagnosis related group for the index hospitalization, and length of hospital stay. All case and control patients had received antibiotics in the 60 days before the index date. For each antibiotic, the risk of CDAD was examined in relation to whether the patient received the antibiotic, after adjustment for use of other antibiotics, demographic characteristics, selected health conditions, and use of healthcare services.Results.The following antibiotics were associated with a significantly increased risk of acquiring CDAD: imipenem-cilastin (odds ratio [OR], 2.77), clindamycin (OR, 2.31), cefuroxime (OR, 2.16), moxifloxacin (OR, 1.88), ceftazidime (OR, 1.82), cefpodoxime (OR, 1.58), ceftizoxime (OR, 1.57), and ceftriaxone (OR, 1.49). Metronidazole and doxycycline were associated with a significantly reduced risk of CDAD (OR for metronidazole, 0.67; OR for doxycycline, 0.41). Other factors associated with an increased risk of CDAD were older age, longer hospital stays, use of proton pump inhibitors, prior gastrointestinal disease, and prior infection (not including C. difficile infection.)Conclusions.Some antibiotics appear to increase the risk of acquiring CDAD, notably clindamycin, third-generation cephalosporins, and carbapenems, whereas metronidazole and doxycycline appear to be protective, compared with other antibiotics.

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