Do fluoroquinolones predispose patients to Clostridium difficile associated disease? A review of the evidence

@article{Deshpande2008DoFP,
  title={Do fluoroquinolones predispose patients to Clostridium difficile associated disease? A review of the evidence},
  author={Abhishek Deshpande and Chaitanya Pant and Anil K. Jain and Thomas G. Fraser and David D. K. Rolston},
  journal={Current Medical Research and Opinion},
  year={2008},
  volume={24},
  pages={329 - 333}
}
ABSTRACT Background: Clostridium difficile associated diarrhea (CDAD) is an important cause of hospital-acquired diarrhea, and increasingly of community-acquired diarrhea. The occurrence of CDAD in the hospitalized patient is associated with increased length of stay, morbidity, mortality, and healthcare costs. Exposure to antimicrobials is the single most important predisposing factor for acquiring CDAD. The data suggesting that fluoroquinolones are an important risk factor for CDAD is becoming… 
Clinical approach to severe Clostridium difficile infection: update for the hospital practitioner.
Clostridium difficile and fluoroquinolones: is there a link?
  • K. Weiss
  • Medicine, Biology
    International journal of antimicrobial agents
  • 2009
Clostridium difficile infection in children: a comprehensive review
TLDR
There is strong evidence for an increased incidence of pediatric CDI in children and early and judicious testing coupled with the timely institution of therapy will help to secure better outcomes for this disease.
Impact of Clostridium difficile infection on inflammatory bowel disease outcome: a review.
TLDR
Most of the studies showed that IBD patients with CDI present a greater proportion of worse outcomes than those without CDI, and further prospective multi-center studies are necessary to evaluate CDI impact on IBD outcome.
Clostridium Difficile–Associated Diarrhea in a Tertiary Care Medical Center
This retrospective, case-control study aimed to identify variables associated with the incidence of Clostridium difficile–associated diarrhea (CDAD) in acute care facilities and to specifically
Antibiotic-associated diarrhea: epidemiology, trends and treatment.
TLDR
The key to addressing AAD is prompt diagnosis followed by effective treatment and institution of control measures, which include the search for other etiologies and more effective treatments.
Susceptibilities of clinical Clostridium difficile isolates to antimicrobials: a systematic review and meta-analysis of studies since 1970.
  • N. Khanafer, N. Daneman, K. Brown
  • Medicine, Biology
    Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
  • 2018
Miscellaneous antibacterial drugs
Evidence for moxifloxacin in community-acquired pneumonia: the impact of pharmaco-economic considerations on guidelines
  • S. Simoens
  • Medicine
    Current medical research and opinion
  • 2009
TLDR
Cap guidelines need to take into account pharmaco-economic considerations by balancing the effectiveness of antimicrobial regimens against their costs, and it may be advisable to identify patient subgroups in which treatment with moxifloxacin is cost-effective and should be recommended by guidelines.
The role of acute care surgery in the treatment of severe, complicated Clostridium difficile–associated disease
TLDR
Novel operative approaches that preserve the colon and minimize operative morbidity may prove to remove the barriers to earlier surgical treatment for fulminant CDAD and improve outcomes.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 29 REFERENCES
Clindamycin, cephalosporins, fluoroquinolones, and Clostridium difficile-associated diarrhea: this is an antimicrobial resistance problem.
  • D. Gerding
  • Medicine, Biology
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2004
TLDR
The saga of CDAD risk and antimicrobial use has been extended to the fluoroquinolone class, as shown by Gaynes et al.
Emergence of fluoroquinolones as the predominant risk factor for Clostridium difficile-associated diarrhea: a cohort study during an epidemic in Quebec.
  • J. Pépin, N. Saheb, L. Lanthier
  • Medicine, Biology
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2005
TLDR
Administration of fluoroquinolones emerged as the most important risk factor for CDAD in Quebec during an epidemic caused by a hypervirulent strain of C. difficile.
A Large Outbreak of Clostridium difficile–Associated Disease with an Unexpected Proportion of Deaths and Colectomies at a Teaching Hospital Following Increased Fluoroquinolone Use
TLDR
Investigation of a large C. difficile outbreak in a hospital to identify risk factors and characterize the outbreak found exposure to levofloxacin was an independent risk factor for C. diffuse-associated diarrhea and appeared to contribute substantially to the outbreak.
Outbreak of Clostridium difficile infection in a long-term care facility: association with gatifloxacin use.
  • R. Gaynes, D. Rimland, F. Tenover
  • Medicine, Biology
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2004
TLDR
It was concluded that an outbreak of CDAD in an LTCF was associated with a formulary change from levofloxacin to gatifloxAcin, and the rate ofCDAD in the LTCf decreased after a change back to levof loxacins.
A predominantly clonal multi-institutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality.
TLDR
A strain of C. difficile that was resistant to fluoroquinolones and had binary toxin and a partial deletion of the tcdC gene was responsible for this outbreak ofC.difficile-associated diarrhea.
Moxifloxacin Therapy as a Risk Factor for Clostridium difficile–Associated Disease During an Outbreak: Attempts to Control a New Epidemic Strain
An outbreak of Clostridium difficile-associated disease (CDAD) caused by the epidemic North American pulsed-field gel electrophoresis type 1 (NAP1) strain began after a formulary change from
Impact of a reduction in the use of high-risk antibiotics on the course of an epidemic of Clostridium difficile-associated disease caused by the hypervirulent NAP1/027 strain.
TLDR
It is suggested that nonrestrictive measures to optimize antibiotic usage can yield exceptional results when physicians are motivated and that such measures should be a mandatory component of n-CDAD control.
Clostridium difficile-associated diarrhea and colitis in adults. A prospective case-controlled epidemiologic study.
TLDR
Cases diagnosed by the presence of cytotoxin or pseudomembranes were found to have been hospitalized longer at diarrhea onset, to have had more antecedent infections, and to have received clindamycin, multiple antimicrobials, and therapeutic antimicro bials more often than controls, but controls received prophylactic antimicroBials more frequently than cases.
Diagnosis and treatment of Clostridium difficile colitis.
TLDR
In patients with recurrent or relapsing colitis, treatment with either metronidazole or vancomycin is effective for that episode, but novel approaches, such as the oral or rectal introduction of competing nonpathogenic organisms, may prove to be more successful in prevention of relapses.
Fluoroquinolone Use and Clostridium difficile–Associated Diarrhea
TLDR
A multivariable regression model showed that treatment with fluoroquinolones was the strongest risk factor for CDAD.
...
1
2
3
...