Antibiotic-associated diarrhea

Giannelli, Frank

doi:10.1097/01.jaa.0000524721.01579.c9

Cited by 25 publications

(16 citation statements)

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“…Previously published studies have shown that increased age is a risk factor for AAD [7,28,29], with older patients being more prone to AAD [2,17]. This study also found that the average age of critically ill patients with AAD was higher than that of patients without AAD.…”

Section: Discussionsupporting

confidence: 77%

Enzyme Inhibitor Antibiotics and Antibiotic-Associated Diarrhea in Critically Ill Patients

et al. 2018

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BackgroundThis study aimed to analyze the factors associated with the development of antibiotic-associated diarrhea (AAD) in critically ill patients receiving enzyme inhibitor antibiotics.Material/MethodsA retrospective study of patients with and without AAD admitted to the intensive care unit (ICU) of the First Teaching Hospital of Xi’an Jiaotong University from February 1, 2014, to January 31, 2016, was undertaken. Relevant clinical data underwent univariate or multivariate regression analysis.ResultsOf 184 patients who received enzyme inhibitor antibiotic therapy, 70 patients (38.04%) developed AAD, with a mean duration of onset of 6.97±3.64 days. AAD was associated with the use of enzyme inhibitor antibiotic therapy alone (OR, 1.142; 95% CI, 1.038–1.256; P=0.007), and in combination with antifungal agents (OR, 2.449; 95% CI, 1.116–5.372; P=0.025), quinolones (OR, 5.219; 95% CI, 1.746–15.601; P=0.003), and oxazolidinones (OR 2.895; 95% CI, 1.183–7.083; P=0.020). The mean duration of ICU stay was significantly increased in patients with AAD (19.00±11.49 days vs. 9.60±6.76 days) (P<0.001). Mean duration of antibiotic therapy (14.09±8.82 days vs. 8.10±4.91 days) (P<0.001) and duration of enzyme inhibitor antibiotic therapy (9.26±5.06 days vs. 6.61±3.24 days) (P<0.001) were significantly increased in patients with AAD.ConclusionsDuration of use of enzyme inhibitor antibiotic therapy and the combined use of antifungals, quinolones, and oxazolidinones increased the incidence and duration of AAD and increased the length of stay in ICU.

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Section: Discussionsupporting

confidence: 77%

Enzyme Inhibitor Antibiotics and Antibiotic-Associated Diarrhea in Critically Ill Patients

et al. 2018

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“…Existing research does not report the correlation between the occurrence of AAD and gender; however, studies have shown that age is a risk factor for AAD [ 10 , 26 , 27 ], with older patients being more prone to AAD [ 5 , 11 ]. When stratified by gender, our data revealed that there was a significant difference in the age of patients, with 56.19±21.03 years as the mean age of males and 47.69±20.24 as the mean age of females.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Antibiotic-Associated Diarrhea in Critically Ill Patients

Guo

Sun

et al. 2018

Med Sci Monit

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BackgroundWe analyzed the factors related to AAD to inform the rational use of antibiotics in critically ill patients and to reduce the incidence of AAD by providing a reference for antibiotic use in the clinical setting.Material/MethodsThis study was a retrospective analysis of the clinical data of patients who were hospitalized in the ICU of the First Teaching Hospital of Xi’an Jiaotong University from January 1, 2015 to December 31, 2016. Patients with AAD were assigned to the case group, and all others were assigned to the control group. Basic data were collected for all the selected patients. All the relevant data were analyzed with univariate or multivariate regression analyses, and P<0.05 was considered statistical significance.ResultsA total of 293 patients were enrolled. Statistical analyses showed that gender (OR 1.915; 95% [CI] 1.061–3.455; P=0.031), parenteral nutrition (OR 1.877; 95% [CI] 1.043–3.377; P=0.036), preventive use of probiotics (OR 0.497; 95% [CI] 0.285–0.866; P=0.014), APACHE II score upon admission to the ICU (OR 0.961; 95% [CI] 0.927–0.998; P=0.037) and use of enzyme-inhibitor antibiotics (OR 1.899; 95% [CI] 1.044–3.420; P=0.016) were associated with AAD. Further subgroup analysis by gender showed that parenteral nutrition (OR 2.144; 95% [CI] 1.064–4.322; P=0.033), preventive use of probiotics (OR 0.367; 95% [CI] 0.186–0.722; P=0.004), and APACHE II score upon admission to the ICU (OR 1.055; 95% [CI] 1.011–1.101; P=0.014) were associated with AAD in critically ill male patients. Age (OR 0.975; 95% [CI] 0.951–0.999; P=0.041) and use of carbapenem antibiotics (OR 4.826; 95% [CI] 1.011–23.030; P=0.048) were associated with AAD in critically ill female patients.ConclusionsParenteral nutrition, prophylactic use of probiotics, use of enzyme-inhibitor antibiotics, and use of combinations of antibiotics were associated with AAD in critically ill patients. The prophylactic use of probiotics may be a protective factor in AAD.

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“…Although the reinforcement of gut microbiota might not directly affect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the gut-lung cross-talk has been implicated in the pathogenesis of some respiratory diseases [ 53 ]. Around 58–71 % of patients suffering from COVID-19 were treated with antibiotics [ 52 ], of which 2–36 % of patients suffered from diarrhea, which might be associated with administrated antibiotics and subsequent dysbiosis [ 54 ]. This led to the suggestion that strengthening the colonic flora might ameliorate vulnerability to secondary infections, and antibiotics induced diarrhea can be managed using probiotics [ 55 , 56 ].…”

Section: Recent Evidence Of Probiotics In Covid-19 - Preclinical and mentioning

confidence: 99%