Increasing contribution of dental antibiotic prescribing to community-acquired Clostridioides difficile infection: a 9-year retrospective cohort study.

IF 3.9 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2026-10-20 DOI:10.1007/s15010-026-03028-x

Božana Miklaušić Pavić, Josip Begovac, Irina Pristaš, Tomislava Skuhala

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引用次数: 0

Abstract

Purpose: Community-acquired Clostridioides difficile infection (CA-CDI) is increasingly recognized outside healthcare settings, yet the contribution of dental antibiotic prescribing remains poorly characterized. This study compared patients with CA-CDI following antibiotics prescribed by dental practitioners versus family physicians.

Methods: We conducted a retrospective cohort study at the University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia, including adults with a first episode of confirmed CA-CDI following outpatient antibiotic exposure between 2011 and 2019. Characteristics were compared by prescriber.

Results: Among 666 patients with CA-CDI, 190 (28.5%) had received antibiotics from dental practitioners and 476 (71.5%) from family physicians. Dental-associated CA-CDI increased significantly over time (13.1% in 2011 to 31.1% in 2019; p = 0.003). Dental patients had a lower comorbidity burden, with less frequent diabetes, chronic obstructive pulmonary disease, and proton pump inhibitor use. Amoxicillin-clavulanate was the most frequently prescribed antibiotic overall; clindamycin was more common among dental patients (39.9% vs. 11.9%), 79.7% of whom had no penicillin allergy. Severity and treatment duration were similar between groups.

Conclusion: Dental antibiotic prescribing emerged as an increasingly important contributor to CA-CDI, associated with higher clindamycin use despite a lower burden of traditional risk factors, highlighting the need to strengthen antimicrobial stewardship in dental practice.

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牙科抗生素处方增加社区获得性艰难梭菌感染的贡献：一项为期9年的回顾性队列研究。

目的：社区获得性艰难梭菌感染（CA-CDI）越来越多地在医疗保健机构之外得到认可，但牙科抗生素处方的贡献仍然缺乏特征。本研究比较了牙科医生和家庭医生开具抗生素后CA-CDI患者。方法：我们在克罗地亚萨格勒布大学传染病医院“Dr. Fran mihaljeviki”进行了一项回顾性队列研究，包括2011年至2019年间门诊抗生素暴露后首次确诊CA-CDI的成年人。不同处方者进行特征比较。结果：666例CA-CDI患者中，190例（28.5%）接受过牙科医生的抗生素治疗，476例（71.5%）接受过家庭医生的抗生素治疗。牙科相关CA-CDI随时间显著增加（2011年为13.1%，2019年为31.1%;p = 0.003）。牙科患者的合并症负担较低，糖尿病、慢性阻塞性肺病和质子泵抑制剂的使用较少。阿莫西林-克拉维酸酯是最常用的抗生素；克林霉素在牙科患者中更为常见（39.9%比11.9%），其中79.7%的患者没有青霉素过敏。两组间严重程度和治疗时间相似。结论：牙科抗生素处方日益成为CA-CDI的重要因素，尽管传统风险因素负担较低，但与克林霉素的较高使用相关，突出了在牙科实践中加强抗菌药物管理的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.