Clostridium difficile and other adverse events from overprescribed antibiotics for acute upper respiratory infection

医学 不利影响 艰难梭菌 抗生素 呼吸道感染 内科学 需要伤害的数量 腹泻 回顾性队列研究 优势比 重症监护医学 相对风险 置信区间 需要治疗的数量 呼吸系统 微生物学 生物
作者
Harris Carmichael,Steven M Asch,Eran Bendavid
出处
期刊:Journal of Internal Medicine [Wiley]
卷期号:293 (4): 470-480
标识
DOI:10.1111/joim.13597
摘要

Guidelines widely recommend avoiding antibiotics for many acute upper respiratory infections (aURIs) to avert adverse events in the absence of likely benefit. However, the extent of harm from these antibiotics remains a subject of debate and could inform patient-centered decision-making. Prior estimates finding a number needed to harm (NNH) between 8 and 10 rely on patient-reported adverse events of any severity. In this analysis, we sought to estimate adverse events by only measuring comparatively severe events that require subsequent clinical evaluation.We constructed a retrospective cohort, including 51 million patient encounters. Using logistic regression models, we determined the adjusted odds ratio (aOR) of clinically detectable adverse events following antibiotic use compared with events among unexposed individuals with aURIs. Our outcomes included candidiasis, diarrhea, Clostridium difficile infection (CDI), and a composite outcome.From our analysis, 62.4% of the population received antibiotics in an aURI encounter. Observed adverse events in the antibiotic-exposed group were 54,279 and 46,936 for diarrhea and candidiasis, respectively, yielding an aOR of 1.24 and 1.61, and an NNH of 3,126 and 1,975. Observed events of CDI in the exposed group were 30,133, and aORs of isolated CDI and combined adverse events were 1.07 and 1.30, resulting in an NNH of 17,695 and 1,150, respectively. Females were more likely to be diagnosed with any adverse event. Overall antibiotics were found to result in 5.7 additional cases of CDI per 100,000 outpatient prescriptions following an upper respiratory tract infection.Despite higher NNH than previous methods of analysis, we find substantial iatrogenic harm associated with prescribing antibiotics in aURIs.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
ylky发布了新的文献求助10
1秒前
科研通AI2S应助浮浮世世采纳,获得10
1秒前
传奇3应助华中科技大学采纳,获得10
1秒前
情怀应助WN采纳,获得10
2秒前
2秒前
5秒前
朴实山兰完成签到,获得积分10
7秒前
9秒前
SciGPT应助ylky采纳,获得10
9秒前
小爪冰凉发布了新的文献求助10
9秒前
10秒前
量子星尘发布了新的文献求助10
10秒前
JamesPei应助科研小牛采纳,获得150
11秒前
Ava应助科研小牛采纳,获得10
11秒前
11秒前
忧郁盼夏发布了新的文献求助10
14秒前
marina关注了科研通微信公众号
14秒前
沐紫心完成签到 ,获得积分10
15秒前
科研通AI5应助suger采纳,获得10
15秒前
17秒前
八九发布了新的文献求助10
17秒前
20秒前
20秒前
一个好听的名字完成签到,获得积分10
21秒前
wbh发布了新的文献求助20
21秒前
21秒前
22秒前
Eddoes完成签到,获得积分10
22秒前
WN发布了新的文献求助10
23秒前
诚心的凌旋完成签到,获得积分10
23秒前
leanne发布了新的文献求助10
25秒前
机智思真完成签到,获得积分10
25秒前
26秒前
科研小牛完成签到,获得积分10
26秒前
归尘发布了新的文献求助10
26秒前
万物安生发布了新的文献求助10
26秒前
阿钉发布了新的文献求助10
26秒前
27秒前
张钦奎发布了新的文献求助10
27秒前
27秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3989378
求助须知:如何正确求助?哪些是违规求助? 3531442
关于积分的说明 11254002
捐赠科研通 3270126
什么是DOI,文献DOI怎么找? 1804887
邀请新用户注册赠送积分活动 882087
科研通“疑难数据库(出版商)”最低求助积分说明 809173