TABLE 1.
Studies examining possible associations between fluoroquinolones and CDIa
| Study (reference) | Study yr | Setting | C. difficile ribotype involved | Quinolone(s) | Study design (no. of positive cases/total no. of cases) | Logistic regression analysis result(s) | Reported relative contribution to CDI cases (%) |
|---|---|---|---|---|---|---|---|
| Yip et al. (217) | 1998 | 300-bed U.S. tertiary-care hospital | Unknown | Ciprofloxacin | Retrospective case-control study (27/54) | Ciprofloxacin OR = 9.5 | |
| Cephalosporin OR = 6.7 | |||||||
| McCusker et al. (129) | 2001 | 778 beds, Veterans Affairs hospital, Baltimore, MD | Unknown | Levofloxacin, ciprofloxacin, gatifloxacin | Retrospective case-control study (30/60) | Fluoroquinolone OR = 12.7 | |
| Cephalosporin OR = 0.4 | |||||||
| Clindamycin OR = 2.2 | |||||||
| Gaynes et al. (71) | 2002 | 173-bed acute-care U.S. hospital | Unknown | Switch levofloxacin to gatifloxacin | Retrospective case-control study (37/59) | Clindamycin and increased duration of gatifloxacin therapy | |
| Muto et al. (139) | 2000-2001 | Pittsburgh, PA | Polyclonal | Levofloxacin | Retrospective case-control study (203/203) | Levofloxacin OR = 2.0 | 31 |
| Ceftriaxone OR = 5.4 | 6.7 | ||||||
| Clindamycin OR = 4.8 | 10 | ||||||
| Loo et al. (121) | 2004 | 12 hospitals in Quebec (8 university and 4 community) | 027 | Ciprofloxacin, gatifloxacin, moxifloxacin | Prospective matched case-control study (237/237) | Fluoroquinolone OR = 3.9 | |
| Cephalosporin OR = 3.8 | |||||||
| Pepin et al. (154) | 2003-2004 | Teaching hospital, Sherbrook, Canada | 027 | Ciprofloxacin, levofloxacin, gatifloxacin, moxifloxacin | Retrospective cohort (293/5,619) | Fluoroquinolone adjusted hazard ratio = 3.44 | 35.9 |
| Cephalosporin adjusted hazard ratio = 1.56-1.89 | 10 | ||||||
| Clindamycin adjusted hazard ratio = 1.77 | 1.5 | ||||||
| Kazakova et al. (98) | 2002-2003 | Community acute-care hospital in Maine | 027 | Levofloxacin, ciprofloxacin | Matched case-control study (68/127) | Fluoroquinolone OR = 3.22 | |
| Cephalosporin OR = 5.19 | |||||||
| McFarland et al. (134) | 2004 | 400-bed Veterans Affairs hospital, Seattle, WA | Unknown | Gatifloxacin | Retrospective matched case-control study (184/184) | Clindamycin OR = 29.9 | |
| Penicillin OR = 4.1 | |||||||
| Biller et al. (23) | 2003 | 320, acute-care, nonteaching U.S. hospital | 027 | Switch levofloxacin to moxifloxacin | Matched case-control study (50/100) | Moxifloxacin OR = 3.14 | |
| Cephalosporin OR = NS | |||||||
| Clindamycin OR = NS | |||||||
| Weiss et al. (207) | 2007 | Two 600-bed tertiary-care hospitals | 027 | Ciprofloxacin, levofloxacin, moxifloxacin | Case-control study (15/31) | Fluoroquinolone OR = 36.2 | |
| Cephalosporin OR = 19.1 | |||||||
| Debast et al. (50) | 2005 | 341-bed community hospital | 027 | Ciprofloxacin | Prospective case-control study (45/90), including extra control group with non-CDI diarrhea (109) | Fluoroquinolone OR = 28.8 | 33 |
| Cephalosporin OR = 7.8 | 56 | ||||||
| Combination OR = 57.5 |
a
NS, not significant.