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    Antibiotic-associated diarrhoea in emergency department observation unit patients

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    Authors
    Haran, John P
    Wu, Gregory
    Bucci, V.
    Fischer, A.
    Keang, L.
    Boyer, Edward W.
    Hibberd, P. L.
    Faculty Advisor
    John Haran, MD
    UMass Chan Affiliations
    Senior Scholars Program
    School of Medicine
    Department of Emergency Medicine
    Document Type
    Journal Article
    Publication Date
    2016-07-01
    Keywords
    antibiotics
    clostridium difficile
    diarrhea
    gastrointestinal infections
    infectious disease
    Bacterial Infections and Mycoses
    Emergency Medicine
    Health Services Administration
    Medical Education
    
    Metadata
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    Link to Full Text
    https://doi.org/10.1017/S0950268816000200
    Abstract
    Clostridium difficile diarrhoea is an urgent threat to patients, but little is known about the role of antibiotic administration that starts in emergency department observation units (EDOUs). We studied risk factors for antibiotic-associated diarrhoea (AAD) and C. difficile infection (CDI) in EDOU patients. This prospective cohort study enrolled adult patients discharged after EDOU antibiotic treatment between January 2013 and 2014. We obtained medical histories, EDOU treatment and occurrence of AAD and CDI over 28 days after discharge. We enrolled and followed 275 patients treated with antibiotics in the EDOU. We found that 52 (18.6%) developed AAD and four (1.5%) had CDI. Patients treated with vancomycin [relative risk (RR) 0.52, 95% confidence interval (CI) 0.3-0.9] were less likely to develop AAD. History of developing diarrhoea with antibiotics (RR 3.11, 95% CI 1.92-5.03) and currently failing antibiotics (RR 1.90, 95% CI 1.14-3.16) were also predictors of AAD. Patients with CDI were likely to be treated with clindamycin. In conclusion, AAD occurred in almost 20% of EDOU patients with risk factors including a previous history of diarrhoea with antibiotics and prior antibiotic therapy, while the risk of AAD was lower in patients receiving treatment regimens utilizing intravenous vancomycin.
    Source
    Epidemiol Infect. 2016 Jul;144(10):2176-83. doi: 10.1017/S0950268816000200. Link to article on publisher's site
    DOI
    10.1017/S0950268816000200
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/49306
    PubMed ID
    27324463
    Notes

    Gregory Wu participated in this study as a medical student as part of the Senior Scholars research program at the University of Massachusetts Medical School.

    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1017/S0950268816000200
    Scopus Count
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    T.H. Chan School of Medicine Student Publications
    Senior Scholars Program
    Emergency Medicine Publications

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