Adverse Drug Reactions including Clostridium difficile
Previous antibiotic exposure is recognized as the single most important risk factor for CDI in adults and children, and nearly all antibiotics have been associated with C difficile disease (Owens RC Jr, Donskey CJ, Gaynes RP, Loo VG, Muto CA. Antibiotic-associated risk factors for Clostridium difficile infection. Clin Infect Dis. 2008;46:(suppl 1 S19-S31)
Lesse et al (NEJM 2015) used active population and laboratory-based surveillance across 10 geographic areas in 2011 to identify the burden of CDI in the United States. Among children 1-17 years, the incidence of CDI was 24.2 per 100,000 persons; with community-associated CDI incidence of 17.9 per 100,000 persons and healthcare associated CDI incidence of 6.3 per 100,000 persons. (Lessa FC, Mu Y, Bamberg WM, Beldavs ZG, Dumyati GK, Dunn JR, et al. Burden of Clostridium difficile infection in the United States. N Engl J Med. 2015 Feb 26;372(9):825-34)
Several studies have noted a rise in CDI-related hospitalizations.
Sammons et al (CID 2013) found that when matched to children without CDI, children with CDI had increased mortality (OR 6.73, 95% CI 3.77-12.02), longer length of hospital stay, and higher hospital costs. (Sammons JS, Localio R, Xiao R, Coffin SE, Zaoutis T. Clostridium difficile infection is associated with increased risk of death and prolonged hospitalization in children. Clin Infect Dis. 2013 Jul;57(1):1-8.)