title: "Collateral damage": antibiotics and the risk of Clostridium difficile infection.
abstract: Patients undergoing orthopedic surgery are at increased risk for infection, and antimicrobial use continues to be required. Antimicrobial selection, however, is an important consideration given the increasing incidence and severity of C. difficile infection described in the literature. When choosing antimicrobials for prophylaxis and treatment, evaluate patients for risk factors that may predispose them to C. difficile infection. Patients receiving multiple antibiotics or broad-spectrum antibiotics, women, patients with concurrent proton pump inhibitor use, and those with renal failure are at increased risk. Choice of antibiotics should be evaluated for their potential or likelihood to cause C. difficile infection. When a number of these risk factors are present, avoiding the use of high-risk antibiotics may be warranted.
authors.affiliation: University of Kentucky Chandler Medical Center, Lexington, 40536, USA.
authors.forename: Felix K
authors.initials: FK
authors.lastname: Yam
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Smith
mesh_terms: D019072:Antibiotic Prophylaxis; D002511:Cephalosporins / Q000009:adverse effects / Q000627:therapeutic use; D002981:Clindamycin / Q000009:adverse effects / Q000627:therapeutic use; D016360:Clostridioides difficile / Q000187:drug effects*; D003967:Diarrhea / Q000139:chemically induced*; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy* / Q000382:microbiology; D024841:Fluoroquinolones / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D010406:Penicillins / Q000009:adverse effects / Q000627:therapeutic use; D011182:Postoperative Care; D011300:Preoperative Care; D012307:Risk Factors
chemical_list: D002511:Cephalosporins; D024841:Fluoroquinolones; D010406:Penicillins; D002981:Clindamycin