Zhou H, Xu Q, Liu Y, Guo LT. Risk factors, incidence, and morbidity associated with antibiotic-associated diarrhea in intensive care unit patients receiving antibiotic monotherapy. World J Clin Cases 2020; 8(10): 1908-1915 [PMID: 32518780 DOI: 10.12998/wjcc.v8.i10.1908]
Corresponding Author of This Article
Li-Tao Guo, MD, PhD, Director, Department of Critical Care Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an 710061, Shaanxi Province, China. glt2002@xjtu.edu.cn
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 26, 2020; 8(10): 1908-1915 Published online May 26, 2020. doi: 10.12998/wjcc.v8.i10.1908
Risk factors, incidence, and morbidity associated with antibiotic-associated diarrhea in intensive care unit patients receiving antibiotic monotherapy
Hong Zhou, Qiang Xu, Yu Liu, Li-Tao Guo
Hong Zhou, Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Qiang Xu, Yu Liu, Li-Tao Guo, Department of Critical Care Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Author contributions: Guo LT designed the study and analyzed the data; all authors contributed to data collection; Zhou H and Xu Q wrote the manuscript; Zhou H and Guo LT revised the manuscript; Liu Y and Guo LT helped select the patients for the study; Zhou H and Xu Q contributed equally to this paper.
Supported bythe Clinical Research Award of the First Affiliated Hospital of Xi’ an Jiaotong University, China, No. XJTU1AF-CRF-2018-011; and the Institutional Foundation of the First Affiliated Hospital of Xi’ an Jiaotong University, No. 2018MS-11.
Institutional review board statement: This study was reviewed and approved by the First Affiliated hospital of Xi'an Jiaotong University Ethics committee, No. XJTU1AF2018LSL-011.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no competing financial interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Li-Tao Guo, MD, PhD, Director, Department of Critical Care Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an 710061, Shaanxi Province, China. glt2002@xjtu.edu.cn
Received: February 19, 2020 Peer-review started: February 19, 2020 First decision: March 18, 2020 Revised: April 9, 2020 Accepted: April 29, 2020 Article in press: April 29, 2020 Published online: May 26, 2020 Processing time: 96 Days and 5.1 Hours
ARTICLE HIGHLIGHTS
Research background
Antibiotic-associated diarrhea (AAD) is diarrhea associated with antibiotic administration. Its incidence has gradually increased and has been reported to be as high as 35% in some studies. AAD has become an important nosocomial disease, especially in critically ill patients. Therefore, we aimed to investigate the factors related to AAD in intensive care unit (ICU) patients receiving antibiotic monotherapy and to provide evidence for clinical anti-infective treatment in critically ill patients.
Research motivation
Currently, research studies on AAD found in the literature are primarily focused on ordinary patients, but a study on AAD in critically ill individuals showed that the incidence of AAD can be as high as 21.6% in cases where antibiotic monotherapy is applied. However, the factors that are associated with AAD in ICU patients with antibiotic monotherapy have not been further explored.
Research objectives
This study aimed to identify factors related to AAD in patients in the ICU receiving antibiotic monotherapy to reduce the incidence of AAD and improve rational use of antibiotics in these patients.
Research methods
A total of 209 patients were enrolled from the ICU of the First Affiliated Hospital of Xi'an Jiaotong University and received antibiotic monotherapy from January 2014 to February 2017. There were 45 cases in the AAD group and 164 cases in the no-AAD group.
Research results
The overall incidence of AAD was 21.53%. Age, proton pump inhibitor usage time, duration of antibiotic, and ICU stay time were associated with AAD. Mean ICU stay time was lower in the no-AAD group (8.49 ± 6.31 vs 15.89 ± 10.69, P < 0.001). However, there was no significant difference in ICU-related mortality rates between the two groups.
Research conclusions
Older age, longer ICU stay time, proton pump inhibitor usage time, and duration of antibiotic increase the incidence of AAD in ICU patients receiving antibiotic monotherapy.
Research perspectives
We aimed to investigate the factors related to AAD in ICU patients receiving antibiotic monotherapy and provide evidence for clinical anti-infective treatment in critically ill patients.
