Association Between Neighbourhood-level Antibiotic Utilization and the Rate of Community-Associated C. difficile (CA-CDI) Infection: An Ecological Study

Clicks: 13
ID: 332800
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #570 of 635 articles by views in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 635 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Background Despite reductions in hospital-associated Clostridioides difficile infection (CDI) incidence in Canada and the United States, the incidence of community-associated CDI (CA-CDI) has remained high. We sought to investigate whether neighbourhood-level variation in antibiotic utilization is associated with CA-CDI. Method We conducted a neighbourhood-level ecological study across 1,520 neighbourhoods in Ontario, Canada. Residents aged ≥66 without hospitalization in the prior 30 days were eligible for inclusion from 2017 to 2023. Antibiotic utilization, CDI cases, and population were identified for each neighbourhood using comprehensive province-wide databases. CA-CDI rate was the outcome (incident cases of CA-CDI/10,000 person-years). Rate of antibiotic utilization (DOT per 1000 person-days) was the primary exposure. The rate-ratio (RR) of CA-CDI associated with increased antibiotic utilization was estimated using negative-binomial regression, adjusting for 8 demographic and health care covariates. We also evaluated risk based on low-, moderate-, and high-risk antibiotic strata based on published literature. Result We identified 19,757 CA-CDI cases. We observed substantial variation in antibiotic utilization across neighbourhoods (Median=21.1 DOT/1000 person-days; interquartile range [IQR], 16.7–25.6). After adjustments, we observed an association between overall antibiotic utilization (RR=1.13 per 10-point increase in DOT; 95% confidence interval [95%CI], 1.09–1.18). A gradient wherein higher risk antibiotic agents were more strongly associated with CA-CDI was apparent (Low-risk: RR=1.08; 95%CI, 1.01–1.15; Moderate-risk: RR=1.27; 95%CI, 1.15–1.39; High-risk: RR=1.73; 95%CI, 1.13–2.66). Discussion Neighbourhoods with higher antibiotic utilization, especially for moderate and high-risk antibiotics, have higher CA-CDI incidence. Reducing variability in neighbourhood antibiotic utilization could help reduce the burden of CDI.
Reference Key
openalex_W7222876182 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Kantaphong Hakin, Nick Daneman, Alejandro Hernández, Bradley J. Langford, Valerie Leung, Kevin L. Schwartz, Kevin Antoine Brown
Are you one of these authors? Claim your profile
Journal Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Year 2026
DOI
10.1093/cid/ciag661
URL
https://doi.org/10.1093/cid/ciag661
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.