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Assessing the Correlation Between Antibiotic Use and Clostridioides Difficile Infection: Insights from a Tennessee Study

The Society for Healthcare Epidemiology of America (SHEA) recently organized a conference where a collaborative study between the Centers for Disease Control and Prevention (CDC) and Davidson County, Tennessee, was presented, focusing on the impacts of previous antibiotic usage on the prevalence of the Clostridioides difficile infection (CDI) across different age cohorts. The study incorporated data collected from 2012 to 2020, during which 7346 confirmed CDI cases were reported in Davidson County. Interestingly, a prevalent majority, approximately 74.4 per cent of the cases, occurred amongst individuals who had been prescribed antibiotics within 12 weeks before their diagnosis.

The study revealed a gradual tapering trend in antibiotic prescription rates from 2012 to 2020, with the percentages for each year recorded as follows: 77.0 per cent, 76.7 per cent, 74.3 per cent, 80.7 per cent, 76.3 per cent, 75.1 per cent, 73.7 per cent, 74.8 per cent, and 71.5 per cent. This decline trend started gaining momentum in 2015, after a brief elevation phase over the 2014 percentages. These findings were presented by Raquel Villegas, PhD, an assistant professor of medicine at Vanderbilt University School of Medicine.

The study further noted age-dependent variations in antibiotic usage: 53.4 per cent for individuals aged 1 to 18 years, 68.8 per cent for 19 to 44 years, 74.5 per cent for 45-64 years, 79.2 per cent for 65 to 74 years, and the highest, 83.1 per cent, for individuals aged 75 and older. The antibiotics most frequently prescribed included ceftriaxone, vancomycin IV, ciprofloxacin, metronidazole, and piperacillin.

The data indicates that infections from CDI and antibiotic prescriptions are complexly interlinked, emphasizing the necessity for detailed studies and the implementation of comprehensive antibiotic stewardship programs for mitigating CDI risks associated with antibiotic usage. This Tennessee study builds upon the foundational metrics for CDI incidence rates in the United States, such as CDC’s surveillance data from multiple sites across the country. Along with the insights from previous research pieces, these findings collectively underline the pressing need for strategic initiatives for preventing CDI, with a special focus on scrutinizing and controlling the prescription of high-risk antibiotics.


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