Antibiotic-associated diarrhoea in emergency department observation unit patients
Faculty Advisor
John Haran, MDDocument Type
Journal ArticlePublication Date
2016-07-01Keywords
antibioticsclostridium difficile
diarrhea
gastrointestinal infections
infectious disease
Bacterial Infections and Mycoses
Emergency Medicine
Health Services Administration
Medical Education
Metadata
Show full item recordAbstract
Clostridium difficile diarrhoea is an urgent threat to patients, but little is known about the role of antibiotic administration that starts in emergency department observation units (EDOUs). We studied risk factors for antibiotic-associated diarrhoea (AAD) and C. difficile infection (CDI) in EDOU patients. This prospective cohort study enrolled adult patients discharged after EDOU antibiotic treatment between January 2013 and 2014. We obtained medical histories, EDOU treatment and occurrence of AAD and CDI over 28 days after discharge. We enrolled and followed 275 patients treated with antibiotics in the EDOU. We found that 52 (18.6%) developed AAD and four (1.5%) had CDI. Patients treated with vancomycin [relative risk (RR) 0.52, 95% confidence interval (CI) 0.3-0.9] were less likely to develop AAD. History of developing diarrhoea with antibiotics (RR 3.11, 95% CI 1.92-5.03) and currently failing antibiotics (RR 1.90, 95% CI 1.14-3.16) were also predictors of AAD. Patients with CDI were likely to be treated with clindamycin. In conclusion, AAD occurred in almost 20% of EDOU patients with risk factors including a previous history of diarrhoea with antibiotics and prior antibiotic therapy, while the risk of AAD was lower in patients receiving treatment regimens utilizing intravenous vancomycin.Source
Epidemiol Infect. 2016 Jul;144(10):2176-83. doi: 10.1017/S0950268816000200. Link to article on publisher's siteDOI
10.1017/S0950268816000200Permanent Link to this Item
http://hdl.handle.net/20.500.14038/49306PubMed ID
27324463Notes
Gregory Wu participated in this study as a medical student as part of the Senior Scholars research program at the University of Massachusetts Medical School.
Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1017/S0950268816000200