Repeated Courses of Antibiotics Linked to Hospital Admissions

For patients with frequent prior antibiotic use, rates of admission remained elevated over six months

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TUESDAY, March 3, 2020 (HealthDay News) -- Repeated courses of antibiotics may be associated with adverse outcomes, including admissions for infection-related complications, according to a study published online March 2 in BMC Medicine.

Tjeerd Pieter van Staa, M.D., Ph.D., from the University of Manchester in the United Kingdom, and colleagues conducted a population-based cohort study to examine the association between frequent antibiotic use and hospital admissions for infection-related complications. Propensity-matched cohorts based on quintiles of prior antibiotic use in the previous three years were identified.

Data were included for 1.8 million patients. The researchers found that repeat antibiotic use was frequent. In all prior exposure quintiles, the highest rates of hospital admissions for infection-related complications were seen shortly after antibiotic initiation. Rates dropped quickly and substantially in patients with limited prior antibiotic use. For patients with frequent prior antibiotic use, reductions over time were substantially less, with the rates remaining elevated over six months. Comparing the highest to the lowest prior exposure quintiles in the Clinical Practice Research Databank, for patients without comorbidity, the incidence rate ratios were 1.18 (95 percent confidence interval, 0.90 to 1.55) in the first three days after prescription; 1.44 (95 percent confidence interval, 1.14 to 1.81) for days 4 to 30 after prescription; and 3.22 (95 percent confidence interval, 2.29 to 4.53) in the three to six months after prescription.

"Antibiotics should be used infrequently for common infections unless there is clear evidence of an infection with susceptible bacteria," the authors write.

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