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Outpatient antibiotics increase risk for C. difficile in the community

Recent emergency room visits, even without antibiotic use, could be a risk factor for the C. difficile infection leading to life-threatening diarrhea.

By Amy Wallace
Outpatient antibiotics increase risk for C. difficile in the community
A recent study suggests outpatient antibiotics increases risk of developing C. difficile infection in the community. File photo by Anawat Sudchanham/Shutterstock

Oct. 26 (UPI) -- Research shows outpatient antibiotic use can increase a person's risk of developing C. difficile infection after discharge from the emergency room.

C. difficile, is a bacterial infection that results in inflammation of the colon known as colitis, according to the Centers for Disease Control and Prevention. Symptoms of the disease include severe diarrhea, fever, loss of appetite, nausea and abdominal pain.

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C. difficile is commonly associated with antibiotic use in hospital settings but beginning in 2014, 41 percent of all C. difficile infections have come from outside hospitals.

Earlier research has detailed how antibiotics can promote C. difficile infection by killing helpful bacteria in the gut.

RELATED Study: Recurring intestinal infections increasing in United States

In that study from 2016, researchers from North Carolina State University found that a single course of antibiotics can allow C. difficile to thrive because the antibiotics kill off bacteria responsible for altering bile acid.

For the current study, published today in Open Forum Infectious Diseases, researchers enrolled 452 patients from 10 U.S. sites from 2014-2015 who tested positive for C. difficile as an outpatient or within three days of being hospitalized, and who had not been admitted to a hospital within the past 12 weeks with each patient being matched with a control who had not tested positive for C. difficile.

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The study showed 82 percent of patients with community-associated C. difficile had previous outpatient healthcare visits, 62 percent had taken antibiotics compared to 58 percent who were not infected and 10 percent who had taken antibiotics.

RELATED Study: 1 in 5 hospitalized adults have side effects from antibiotics

"There's a lot of work that needs to be done in terms of improving outpatient prescribing practices and making sure that providers are appropriately prescribing antibiotics," Dr. Alice Y. Guh, of the CDC, said in a press release.

"Health-care associated C. difficile infection is still a huge burden, but there is increasingly more recognition that community-associated C. difficile can occur. Outpatient antibiotic use is a risk factor, and we need to improve antibiotic stewardship not just in inpatient settings but also outpatient settings."

The findings point to emergency rooms being the source of infection in the community.

RELATED Antibiotic overuse behind 'superbug' outbreak in U.K. hospitals

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