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Prevalence and management of antibiotic associated diarrhea in general hospitals.

Elseviers MM, Van Camp Y, Nayaert S, Duré K, Annemans L, Tanghe A, Vermeersch S - BMC Infect. Dis. (2015)

Bottom Line: Antibiotic-associated diarrhea (AAD) is a common adverse effect of antibiotic (AB) treatment.AAD was significantly associated with higher age and the use of double AB and proton pump inhibitors.Preventive action are highly recommended to reduce the prevalence of AAD and associated health care costs.

View Article: PubMed Central - PubMed

Affiliation: Centre for Research and Innovation in Care (CRIC), Faculty of Medicine and Health Sciences, University of Antwerp, CDE R3.29, Universiteitsplein 1, B-2610, Wilrijk, Antwerp, Belgium. monique.elseviers@uantwerpen.be.

ABSTRACT

Background: Antibiotic-associated diarrhea (AAD) is a common adverse effect of antibiotic (AB) treatment. This study aimed to measure the overall prevalence of AAD (including mild to moderate diarrhea) in hospitalized AB treated patients, to investigate associated risk factors and to document AAD associated diagnostic investigations, contamination control and treatment.

Methods: During 8 observation days (with time delay of 10-14 days between each observation day), all adult patients hospitalized at an internal medicine ward of 4 Belgian participating hospitals were screened for AB use. Patients receiving AB on the observation day were included in the study and screened for signs and symptoms of AAD using a period prevalence methodology. Clinical data were collected for all AB users and AAD related investigations and treatment were collected for the entire duration of AAD. Additionally, nurses noted daily the frequency of all extra care associated to the treatment of the diarrhea.

Results: A total of 2543 hospitalized patients were screened of which 743 were treated with AB (29.2%). Included AB users had a mean age of 68 yr (range 16-99) and 52% were male. Penicillins were mostly used (63%) and 19% received more than one AB. AAD was observed in 9.6% of AB users including 4 with confirmed Clostridium difficile infection. AAD started between 1 and 16 days after AB start (median 5) and had a duration of 2 to 41 days (median 4). AAD was significantly associated with higher age and the use of double AB and proton pump inhibitors. AAD patients had extra laboratory investigations (79%), received extra pharmacological treatment (42%) and 10 of them were isolated (14%). AAD related extra nursing time amounted to 51 minutes per day for the treatment of diarrhea.

Conclusions: In this observational study, with one third of hospitalized patients receiving AB, an AAD period prevalence of 9.6% in AB users was found. AAD caused extra investigations and treatment and an estimated extra nursing care of almost one hour per day. Preventive action are highly recommended to reduce the prevalence of AAD and associated health care costs.

No MeSH data available.


Related in: MedlinePlus

Screening procedure for inclusion of antibiotic users (= point prevalence of AB use) and antibiotic associated diarrhea (= period prevalence of AAD).
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Related In: Results  -  Collection

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Fig1: Screening procedure for inclusion of antibiotic users (= point prevalence of AB use) and antibiotic associated diarrhea (= period prevalence of AAD).

Mentions: In all adult patients, hospitalized in one of the internal medicine wards of four participating hospitals, a point prevalence methodology was used to screen for AB use (Figure 1). Charts from all patients treated with AB on the observation day were investigated for signs and symptoms of AAD on that day as well as in the week before and the week after (period prevalence). In patients with AAD, related diagnostic procedures, contamination control, AAD treatment and extra nursing care were registered.Figure 1


Prevalence and management of antibiotic associated diarrhea in general hospitals.

Elseviers MM, Van Camp Y, Nayaert S, Duré K, Annemans L, Tanghe A, Vermeersch S - BMC Infect. Dis. (2015)

Screening procedure for inclusion of antibiotic users (= point prevalence of AB use) and antibiotic associated diarrhea (= period prevalence of AAD).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4403881&req=5

Fig1: Screening procedure for inclusion of antibiotic users (= point prevalence of AB use) and antibiotic associated diarrhea (= period prevalence of AAD).
Mentions: In all adult patients, hospitalized in one of the internal medicine wards of four participating hospitals, a point prevalence methodology was used to screen for AB use (Figure 1). Charts from all patients treated with AB on the observation day were investigated for signs and symptoms of AAD on that day as well as in the week before and the week after (period prevalence). In patients with AAD, related diagnostic procedures, contamination control, AAD treatment and extra nursing care were registered.Figure 1

Bottom Line: Antibiotic-associated diarrhea (AAD) is a common adverse effect of antibiotic (AB) treatment.AAD was significantly associated with higher age and the use of double AB and proton pump inhibitors.Preventive action are highly recommended to reduce the prevalence of AAD and associated health care costs.

View Article: PubMed Central - PubMed

Affiliation: Centre for Research and Innovation in Care (CRIC), Faculty of Medicine and Health Sciences, University of Antwerp, CDE R3.29, Universiteitsplein 1, B-2610, Wilrijk, Antwerp, Belgium. monique.elseviers@uantwerpen.be.

ABSTRACT

Background: Antibiotic-associated diarrhea (AAD) is a common adverse effect of antibiotic (AB) treatment. This study aimed to measure the overall prevalence of AAD (including mild to moderate diarrhea) in hospitalized AB treated patients, to investigate associated risk factors and to document AAD associated diagnostic investigations, contamination control and treatment.

Methods: During 8 observation days (with time delay of 10-14 days between each observation day), all adult patients hospitalized at an internal medicine ward of 4 Belgian participating hospitals were screened for AB use. Patients receiving AB on the observation day were included in the study and screened for signs and symptoms of AAD using a period prevalence methodology. Clinical data were collected for all AB users and AAD related investigations and treatment were collected for the entire duration of AAD. Additionally, nurses noted daily the frequency of all extra care associated to the treatment of the diarrhea.

Results: A total of 2543 hospitalized patients were screened of which 743 were treated with AB (29.2%). Included AB users had a mean age of 68 yr (range 16-99) and 52% were male. Penicillins were mostly used (63%) and 19% received more than one AB. AAD was observed in 9.6% of AB users including 4 with confirmed Clostridium difficile infection. AAD started between 1 and 16 days after AB start (median 5) and had a duration of 2 to 41 days (median 4). AAD was significantly associated with higher age and the use of double AB and proton pump inhibitors. AAD patients had extra laboratory investigations (79%), received extra pharmacological treatment (42%) and 10 of them were isolated (14%). AAD related extra nursing time amounted to 51 minutes per day for the treatment of diarrhea.

Conclusions: In this observational study, with one third of hospitalized patients receiving AB, an AAD period prevalence of 9.6% in AB users was found. AAD caused extra investigations and treatment and an estimated extra nursing care of almost one hour per day. Preventive action are highly recommended to reduce the prevalence of AAD and associated health care costs.

No MeSH data available.


Related in: MedlinePlus