Abstract

Background

Antibiotic use is a major risk factor for Clostridioides difficile infection (CDI). However, antibiotics recommended for CDI treatment are being utilized in clinical practice as prophylactic agents.

Objectives

To comprehensively summarize and critically evaluate the published literature investigating the effectiveness of antibiotic CDI prophylaxis.

Methods

A systematic search for relevant literature was conducted in PubMed and ClinicalTrials.gov. Two investigators independently screened each article for inclusion, and the references of the included articles were studied to identify additional relevant articles. Data extraction and an assessment of risk of bias was completed for all included studies. Unadjusted risk ratios and 95% CI were calculated for each study, with CDI being the outcome variable and prophylaxis (prophylaxis versus control) representing the exposure.

Results

In total, 13 articles were identified in PubMed and 9 ongoing or unpublished trials were identified in ClinicalTrials.gov. The effect of antibiotic prophylaxis on CDI rates varied between studies; however, most favoured the use of antibiotic prophylaxis.

Conclusions

The authors of this review conclude that the current literature carries a high risk of bias and the results should be interpreted with caution.

中文翻译：

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利用抗生素预防艰难梭菌感染：接触危险因素会降低风险吗？系统的审查。

摘要

背景

抗生素的使用是艰难梭菌（Clostridioides difficile）感染（CDI）的主要危险因素。但是，推荐用于CDI治疗的抗生素已在临床实践中用作预防剂。

目标

为了全面总结和批判性地评估研究抗生素CDI预防效果的文献。

方法

在PubMed和ClinicalTrials.gov中对相关文献进行了系统搜索。两名研究人员独立筛选了每篇文章的收录内容，并对其中所含文章的参考文献进行了研究，以确定其他相关文章。所有纳入研究均完成了数据提取和偏倚风险评估。为每项研究计算未经调整的风险比和95％CI，其中CDI为结果变量，而预防（预防与对照）代表暴露。

结果

在PubMed中总共鉴定出13篇文章，在ClinicalTrials.gov中鉴定出9项正在进行或未发表的试验。抗生素预防对CDI发生率的影响因研究而异。但是，最赞成使用抗生素预防。

结论

这篇综述的作者得出结论，当前文献存在很高的偏见风险，应谨慎解释结果。