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[Clostridium difficile-associated diarrhea--a growing problem in geriatric care].
T Cederholm1, J Larsson, O Ericsson
1Geriatriska kliniken, Huddinge Universitetssjukhus, Huddinge. tommy.cederholm@ger.hs.sll.se
Lakartidningen
|March 27, 2001
Summary
Clostridium difficile-associated diarrhoea (CDAD) incidence significantly rose in geriatric patients, correlating with increased antibiotic use, particularly cephalosporins. Patients with CDAD experienced longer hospital stays compared to controls.
Area of Science:
- Geriatric Medicine
- Infectious Diseases
- Hospital Epidemiology
Background:
- Clostridium difficile-associated diarrhoea (CDAD) poses a significant risk in healthcare settings.
- Surveillance data from 1994-1998 indicated a rise in CDAD within a geriatric department.
Purpose of the Study:
- To investigate the incidence of CDAD in a geriatric medicine department.
- To explore the association between antibiotic consumption and CDAD rates.
- To compare hospital stay duration between CDAD patients and a control group.
Main Methods:
- Retrospective analysis of CDAD incidence and antibiotic consumption from 1994 to 1998.
- Comparison of CDAD rates in a geriatric department versus the entire hospital.
- Matched case-control study comparing antibiotic exposure and hospital stay.
Main Results:
- CDAD incidence in the geriatric department increased from 0.5% to 2.2% between 1994 and 1998.
- Antibiotic consumption more than doubled during the study period, with cephalosporins (e.g., cefuroxime) accounting for 48% of prescriptions in CDAD patients.
- Patients with CDAD had significantly longer hospitalizations (27 days) compared to the reference group (13 days).
Conclusions:
- Increased antibiotic use, especially cephalosporins, is strongly associated with a rise in CDAD among geriatric patients.
- CDAD contributes to prolonged hospital stays in the elderly population.
- Enhanced infection control measures and judicious antibiotic stewardship are crucial in geriatric wards.