J Korean Med Sci.  2020 Dec;35(47):e407. 10.3346/jkms.2020.35.e407.

Association between Antibiotic Consumption and Incidence of Clostridioides difficile Infection in a Hospital

  • 1Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea


Previous exposure to antimicrobials is a major risk factor for Clostridioides difficile infection (CDI). Antibiotic prescription and C. difficile toxin assay records of patients admitted to a tertiary hospital in Korea from 2009 to 2013 were collected to investigate the association between antibiotic consumption and CDI incidence. A Spearman's correlation analysis between CDI incidence (positive result of toxin assay/10,000 admissions) and antibiotic consumption (defined daily dose/1,000 patient-days) was performed on a monthly basis. Using the matched month approach, we found a significant correlation between CDI rate and moxifloxacin consumption (Spearman's r = 0.351, P < 0.001). Furthermore, using the onemonth delay approach, we found that the consumption of clindamycin (Spearman's r = 0.272, P = 0.037) and moxifloxacin (Spearman's r = 0.297, P = 0.022) was significantly correlated with CDI incidence. Extended-spectrum cephalosporins did not have any effect on CDI incidence.


Clostridioides difficile; Antibiotics; Correlation; Stewardship; Korea
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