Incidence of and risk factors for community-associated Clostridium difficile infection: A nested case-control study

Table 3 Association between antimicrobial use in the previous 180 days and community-associated C. difficile infection

	CA-CDI Cases	Controls	Unadjusted OR	Adjusted OR
	(N = 304)	(N = 3040)	(95% CI)	(95% CI)*
Antimicrobial Drug/Class^†
Beta-lactam/beta-lactamase inhibitors	46 (15.13)	95 (3.12)	5.58 (3.79, 8.20)	5.10 (3.26, 8.00)
Cephalosporins	75 (24.67)	230 (7.57)	4.06 (3.02, 5.47)	3.11 (2.17, 4.45)
Clindamycin	35 (11.51)	26 (0.86)	15.65 (9.09, 26.95)	13.00 (7.03, 24.04)
Fluoroquinolones	67 (22.04)	94 (3.09)	8.33 (5.94, 11.67)	4.91 (3.28, 7.35)
Macrolides	61 (20.07)	300 (9.87)	2.27 (1.68, 3.07)	2.19 (1.54, 3.11)
Penicillins	50 (16.45)	291 (9.57)	1.86 (1.34, 2.58)	1.72 (1.17, 2.54)
Sulfonamides	16 (5.26)	52 (1.71)	3.16 (1.79, 5.60)	1.58 (0.79, 3.15)
Tetracyclines	11 (3.62)	78 (2.57)	1.43 (0.75, 2.71)	0.94 (0.43, 2.04)
Timing of Antimicrobial Use
No Use	82 (26.97)	2120 (69.74)	reference	reference
Within 1-30 Days	141 (46.38)	304 (10.00)	12.06 (8.88, 16.36)	13.02 (9.37, 18.09)
Within 31-60 Days	36 (11.84)	148 (4.87)	6.25 (4.06, 9.63)	5.84 (3.68, 9.28)
Within 61-90 Days	15 (4.93)	151 (4.97)	2.50 (1.40, 4.47)	2.30 (1.24, 4.25)
Within 91-120 Days	17 (5.59)	144 (4.74)	2.84 (1.63, 4.93)	2.30 (1.27, 4.17)
Within 121-150 Days	9 (2.96)	97 (3.19)	2.30 (1.12, 4.73)	2.77 (1.29, 5.95)
Within 151-180 Days	4 (1.32)	76 (2.50)	1.39 (0.50, 3.91)	1.17 (0.40, 3.41)
Number of Antimicrobials [Mean (SD)]	1.26 (1.10)	0.39 (0.68)	2.72 (2.40, 3.09)	2.74 (2.38, 3.15)

NOTE. Data are presented as the number (%) of patients, unless otherwise stated.
^* Adjusted for age, gender, history of hospitalization, Charlson Comorbidity Index, inflammatory bowel disease, and gastric acid suppressant use
^† Antimicrobial classes were entered in a multivariable model as a series of indicator variables (i.e., ORs are adjusted for the use of other classes).

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