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JAC Advance Access published online on November 20, 2008
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkn477
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
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Leading article

What have we learned about antimicrobial use and the risks for Clostridium difficile-associated diarrhoea?

J. M. Blondeau*

Department of Clinical Microbiology, Royal University Hospital and Saskatoon Health Region, Saskatoon, Saskatchewan, Canada; Departments of Microbiology and Immunology and Pathology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada

* Department of Microbiology, Royal University Hospital, 103 Hospital Drive, Saskatoon, Saskatchewan, Canada S7N 0W8. Tel: +1-306-655-6943; Fax: +1-306-655-6947; E-mail: joseph.blondeau{at}saskatoonhealthregion.ca

Clostridium difficile is recognized as a major cause of antibiotic-associated diarrhoea and colitis. Antimicrobial agents have been repeatedly recognized as a causative risk for C. difficile-associated diarrhoea (CDAD) and more recently fluoroquinolones have been particularly implicated. Unfortunately, not all reports of antimicrobial associations with CDAD have excluded variables other than antimicrobial use. Prevention of CDAD usually involves infection control interventions and antimicrobial restriction policies may not be fully substantiated by currently available data; however, antimicrobial drug restriction seems prudent in outbreak situations.

Key Words: antibiotics , hospital-acquired CDAD , anaerobes


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