Perioperative Antibiotic Prophylaxis Is a Risk Factor for C. difficile Infection

With increasing incidence and virulence of Clostridium difficile infections (CDIs), is the risk-benefit ratio of perioperative antibiotic prophylaxis changing? To find out, researchers retrospectively assessed risk for CDIs among adults who underwent abdominal hysterectomy, hip arthroplasty, craniotomy, or colon, cardiac, or vascular surgery at a Quebec tertiary care hospital between 1999 and 2005.

A total of 7657 patients underwent 8367 such surgical procedures during the study period. Among 5502 procedures in which patients received no antibiotics other than perioperative prophylaxis, the CDI rate was 7.3 cases per 1000 procedures. Infection rates were 7.9 cases per 1000 procedures for those in which patients received antibiotics for treat…