Impact of doxycycline on Clostridioides difficile infection in patients hospitalized with community-acquired pneumonia.
Am J Infect Control
; 52(3): 280-283, 2024 Mar.
Article
en En
| MEDLINE
| ID: mdl-37921728
ABSTRACT
BACKGROUND:
Antibiotic use is a significant risk factor associated with Clostridioides difficile (C difficile) infection (CDI). Community-acquired pneumonia (CAP) is a common infection leading to hospital admission and the use of antibiotics that are highly associated with CDI. It has been proposed that doxycycline, a tetracycline antibiotic, may be protective against CDI.METHODS:
A retrospective analysis was conducted in hospitalized patients in Veterans Affairs Hospitals across the United States to determine if doxycycline was associated with a decreased risk of CDI. The primary outcome was the development of CDI within 30 days of initiation of doxycycline or azithromycin, as part of a standard pneumonia regimen.RESULTS:
Approximately 156,107 hospitalized patients who received care at a Veterans Affairs Hospital and were diagnosed with CAP during the study timeframe were included. A 17% decreased risk of CDI was identified with doxycycline compared to azithromycin when used with ceftriaxone for the treatment of pneumonia (P = .03). In patients who had a prior history of CDI, doxycycline decreased the incidence of CDI by 45% (odds ratio 0.55; P = .02).CONCLUSIONS:
Doxycycline is associated with a lower risk of CDI compared to azithromycin when used for atypical coverage in CAP. Thus, patients who are at such risk may benefit from doxycycline as a first-line agent for atypical coverage, rather than the use of a macrolide antibiotic, if Legionella is not of concern.Palabras clave
Texto completo:
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Bases de datos:
MEDLINE
Asunto principal:
Neumonía
/
Infección Hospitalaria
/
Clostridioides difficile
/
Infecciones por Clostridium
/
Infecciones Comunitarias Adquiridas
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Am J Infect Control
Año:
2024
Tipo del documento:
Article