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.