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Prescribing antibiotics to hospitalised patients increases the risk of Clostridium difficile infection for the next bed occupant
  1. Nick Daneman
  1. Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Nick Daneman, Sunnybrook Research Institute, University of Toronto, Toronto, ON M4N 3M5, Canada; nick.daneman{at}

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Commentary on: Freedberg DE, Salmasian H, Cohen B, et al. Receipt of antibiotics in hospitalized patients and risk for Clostridium difficile infection in subsequent patients who occupy the same bed. JAMA Intern Med 2016;176:1801–8.


Patients are at heightened risk of Clostridium difficile-associated disease when they are exposed to both the organism and to antibiotic treatments, which deplete their normal, diverse, protective gastrointestinal flora. Both of these factors are prevalent in healthcare facilities, and thus C. difficile is the most common and most burdensome hospital-acquired pathogen.1 The hazards of antibiotic use may extend beyond the individual patient. As ward-level antibiotic use increases, so too does an individual patient’s risk of C. difficile infection, even when he or she has not directly received antibiotics.2 In this study, Freedberg et al aim to provide perhaps the most direct evidence of the indirect hazards of antibiotic use on the risk of C. difficile—by testing whether antibiotic receipt by a …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.