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Surgical antibiotic prophylaxis and Clostridium difficile toxin positivity
D Kreisel1, T G Savel, A L Silver
1Department of Surgery, Mount Sinai School of Medicine, New York, NY, USA.
Archives of Surgery (Chicago, Ill. : 1960)
|September 1, 1995
Summary
Prolonged prophylactic antibiotic therapy (PAT) in surgery increases Clostridium difficile toxin (CDT) positivity risk. Appropriate PAT use can reduce costs by lowering CDT rates and hospital stays.
Area of Science:
- Infectious Diseases
- Surgical Outcomes
- Antibiotic Stewardship
Background:
- Clostridium difficile toxin (CDT) positivity is a significant healthcare concern.
- Prophylactic antibiotic therapy (PAT) is commonly used in surgical procedures.
Purpose of the Study:
- To investigate the association between prophylactic antibiotic therapy (PAT) and the development of Clostridium difficile toxin (CDT) positivity.
- To evaluate the impact of PAT use on patient outcomes.
Main Methods:
- Retrospective case-control study involving 357 patients.
- Analysis of patients with positive CDT assays and matched controls.
- Assessment of PAT appropriateness and duration.
Main Results:
- Inappropriate PAT use was associated with a significantly higher risk of CDT positivity (odds ratio, 5.1).
- CDT-positive patients had a longer duration between operation and final antibiotic dose (3.1 vs 1.7 days).
- CDT-positive patients experienced longer hospital stays (16.5 vs 10.2 days).
Conclusions:
- Prolonged PAT in elective surgery elevates the risk of CDT positivity.
- Appropriate PAT use can decrease CDT rates, shorten hospital stays, and reduce healthcare costs.
- Implementation of restrictive policies for PAT is recommended to prevent antibiotic misuse.