Comparison of pediatric and adult antibiotic-associated diarrhea and Clostridium difficile infections

Table 2 Comparison of risk factors for pediatric antibiotic-associated diarrhea vs adult antibiotic-associated diarrhea and pediatric Clostridium difficile infections vs adult Clostridium difficile infections from multivariate analyses

Host Factors	Pediatric AAD	Ref.	Adult AAD	Ref.	Pediatric CDI	Ref.	Adult CDI	Ref.
Age	< 2 yr (RR = 1.8)	Turck[63]	> 70 yr	Elseviers[37]	1-4 yr	Tai[67]	> 65 yr	Hu[189]
			> 70 yr	Asha[22]	6 mo-2 yr	McFarland[1]	> 65 yr	Beaulieu[190]
							> 65 yr	Vardakas[74]
							> 65 yr	Pepin[106]
							> 65 yr	McFarland[89]
							> 85 yr	Vesteinsdottir[73]
							Yes (RR = 1.2)	Eyre[118]
							Yes (HR = 1.4)	Marwick[191]
Comorbidity	NR		No	Elseviers[37]	Yes (OR = 1.1)	Sammons[44]	Yes (OR = 1.3)	McFarland[121]
					Yes (OR = 1.1)	Tai[67]	Yes (OR = 4)	Wenisch[102]
					Yes (OR = 2.0)	Samady[68]	No	Tabak[117]
							No	Vesteinsdottir[73]
Chemotherapy	NR		No	Elseviers[37]	Yes (HR = 1.9)	de Blank[69]	Yes (OR =2.3)	Dubberke[192]
or cancer					Yes (OR = 3.8)	Tai[67]	Yes (OR = 3.6)	Huang[65]
					Yes (RR = 2.7)	Sathyendan[38]
IBD	NR		No	Elseviers[37]	Yes (OR = 11.4)	Hourigan[187]	Yes (OR = 3.3)	Hourigan[187]
					Yes (OR = 11.4)	Nyland[14]	No	Leung[179]
					Yes (OR = 4.5)	Kelsen[188]
Prior GI condition	NR		NR		NR		Yes (OR = 2.8)	McFarland[121]
Immuno-deficiency	NR		NR		Yes (OR = 6.0)	Samady[68]	NR
					Yes (OR = 8.1)	Sandora[66]
Disruptive factors
Previous antibiotics	NR		OR = 2.3	Elseviers[37]	Yes (OR = 1.2)	Sathyendan[38]	Yes (OR = 1.3)	Loo[57]
					Yes (OR = 2.2)	Sandora[66]	Yes (HR = 1.4)	Stevens[173]
							Yes (RR = 2.1)	McFarland[121]
					Yes (RR = 2.8)	Samady[68]	Yes (HR = 3.4)	Marwick[191]
							Yes (OR = 3.6)	Huang[65]
Type of antibiotic	Amoxicillin/clavulanate (RR = 2.4)	Turck[63]			Amino (HR = 1.3) and Ceph (HR = 2.4)	de Blank[69]	Clind (OR = 4.3) Ceph (RR = 3.8)	Johnson[56] Asha[22]
					Quino	Sandora[66]	Diclox, Clind,	Vesteinsdottir[73]
					(OR = 17.0)		Ceftriaxone
							(OR = 2.2-7.5)
							Ceph and Pen	McFarland[64]
							(OR = 2.1)
							Clind, Quino,	Loo[57]
							Ceph (OR = 3.8)
							Clind/Levo/Ceftrizone (OR = 3.0)	Muto[59]
							Cefoxitin (OR = 2.7)	Carignan[183]
							Ceph (OR = 5.6)	Dubberke[192]
							Quino (HR = 3.4)	Pépin[58]
No prior antibiotics < 2-8 wk prior	NR		NR		2%	Sammons[44]	6%	McFarland[64]
					5%	Duleba[18]	13%	Khanna[17]
					8%	Samady[68]	20%	McFarland[121]
					13%	Chen[167]	40%	Loo[57]
					19%	Crews[12]	96% (CO)	Fellmeth[75]
					22%	Khanna[40]
					27%	Pai[71]
					43% (CO)	Benson[70]
					67% (CO)	Wendt[4]
Abdominal surgery	NR		NR		Yes (OR = 3.3)	Sandora[66]	Yes (OR = 2.6)	Huang[65]
							Yes (OR = 2.8)	Zerey[193]
PPI	NR		OR = 2.0	Elseviers[37]	Yes (HR = 1.4)	de Blank[69]	Yes (OR = 1.6)	Dubberke[192]
			OR = 2.8	Asha[22]	Yes (RR= 1.7)	Sathyendan[38]	Yes (OR = 1.8)	Muto[59]
					Yes (RR = 2.4)	Nylund[181]	Yes (OR = 2.8)	Stevens[173]
					Yes (OR = 4.2)	Samady[68]	Yes (OR = 6.1)	Peled[25]
					No	Brown[194]	No	Khanna[17]
					No	Sandora[66]	No	Leung[179]
					No	Sammons[44]	No	Vesteinsdottir[73]
							No	Pépin[58]
							No	Marwick[191]
							No	Huang[65]
Histamine-2 receptor antagonist	NR		NR		Yes (RR = 2.2)	Brown[194]	Yes (OR = 3.1)	Peled[25]
Exposure to C. difficile spores
Prior hospitalization	NR		NR		Yes (OR = 1.7)	Tai[67]	Yes (OR = 1.3)	McFarland[121]
					Yes	Samady[68]	Yes (OR = 2.0)	Eyre[118]
					(OR = 2.3)		Yes (RR = 2.3)	Vesteinsdottir[73]
					No	Sandora[66]	Yes (HR = 4.7)	Marwick[191]
							Yes (RR = 5.1)	McFarland[64]
							No	Huang[65]
Prior long term care residence	NR		NR		NR		Yes (OR = 3.9)	Vesteinsdottir[73]
							Yes (HR = 4.1)	Marwick[191]
Prolonged length of stay (current)	NR		NR		Yes (OR = 15)	Tai[67]	Yes (RR = 1.01)	Asha[22]
							Yes (OR = 2.8)	Huang[65]
							Yes (OR = 5.1)	Lee[195]
							No	Carignan[183]
Infected roommates/CD proximity/CD pressure	NR		NR		NR		Yes (RR = 1.7)	McFarland[45]
							Yes (OR = 4.0)	Dubberke[192]
Previous CDI	NR		NR		NR		Yes (HR = 4.5)	Stevens[173]
							No	Khanna[17]

References are given by last name of first author and citation number in brackets. AAD: Antibiotic-associated diarrhea; Amino: Aminoglycoside; CDI: Clostridium difficile infections; IBD: Inflammatory bowel disease; Ceph: Cephalosporins; Clind: Clindamycin; CO: Community-onset; Diclox: Dicloxacillin; HR: Hazard ratio; Levo: Levofloxacin; NR: Not reported; OR: Odds ratio; Pen: Penicillin; PPI: Proton-pump inhibitor; RR: Relative risk; Quino: Quinolones.