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Quinolone Use as a Risk Factor for Nosocomial Clostridium difficile-Associated Diarrhea

  • Clarwyn Yip (a1), Mark Loeb (a2) (a3), Suzette Salama (a1), Lorraine Moss (a2) and Jan Olde (a3)...



To determine modifiable risk factors for nosocomial Clostridium difficile-associated diarrhea (CDAD).


Case-control study.


300-bed tertiary-care hospital.


Hospital inpatients present during the 3-month study period.


Case-patients identified with nosocomial CDAD over the study period were compared to two sets of control patients: inpatients matched by age, gender, and date of admission; and inpatients matched by duration of hospital stay. Variables including demographic data, comorbid illnesses, antibiotic exposure, and use of gastrointestinal medications were assessed for case- and control-patients. Conditional logistic regression was performed to identify risk factors for nosocomial CDAD.


27 case-patients were identified and were compared to the two sets of controls (1:1 match for each comparison set). For the first set of controls, use of ciprofloxacin (odds ratio [OR], 5.5; 95% confidence interval [CI95], 1.2-24.8; P=.03) was the only variable that remained significant in the multivariable model. For the second set of controls, prior exposure to cephalosporins (OR, 6.7; CL,5, 1.3-33.7; P=.02) and to ciprofloxacin (OR, 9.5; CI95, 1.01-88.4; P=.05) were kept in the final model.


Along with cephalosporins, prior quinolone use predisposed hospitalized patients to nosocomial CDAD. Quinolones should be used judiciously in acute-care hospitals, particularly in those where CDAD is endemic.


Corresponding author

Hamilton Health Sciences Corporation, 711 Concession St, Hamilton, Ontario L8V1C3, Canada


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Quinolone Use as a Risk Factor for Nosocomial Clostridium difficile-Associated Diarrhea

  • Clarwyn Yip (a1), Mark Loeb (a2) (a3), Suzette Salama (a1), Lorraine Moss (a2) and Jan Olde (a3)...


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