Mortality of patients with antibiotic-associated diarrhoea: the impact of Clostridium difficile

J. Bishara*, N. Peled, S. Pitlik, Z. Samra

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Previous studies have shown conflicting results concerning mortality related to Clostridium difficile infection. The objective of this study was to determine the impact of C. difficile infection on short- and long-term mortality in hospitalised patients with antibiotic-associated diarrhoea. We therefore undertook a prospective case-control study of 217 hospitalised patients who received antibiotics, developed diarrhoea and underwent stool enzyme immunoassay for C. difficile TOX A/B. The Kaplan-Meier and the log-rank test were used to determine univariate survival analysis and a Cox regression model for multivariate analysis of 28 day and long-term mortality. Fifty-two (24%) of the 217 patients who met the study criteria were positive for C. difficile TOX A/B. The crude 28 day and long-term mortality rates of the entire cohort were 12.4% and 56%, respectively. On Cox regression analysis, hypoalbuminaemia, impaired functional capacity and elevated serum urea levels were found to be the only independent and statistically significant variables associated with long-term mortality. C. difficile toxin positivity per se was not associated with increased short- or long-term mortality rates. In conclusion, hypoalbuminaemia, renal failure, and impaired function capacity predict mortality due to antibiotic-associated diarrhoea, but C. difficile involvement by itself does not further increase the risk of death in these patients.

Original languageEnglish
Pages (from-to)308-314
Number of pages7
JournalJournal of Hospital Infection
Issue number4
StatePublished - Apr 2008
Externally publishedYes


  • Antibiotic
  • Clostridium difficile
  • Diarrhoea
  • Long term
  • Mortality


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