{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T14:55:15Z","timestamp":1779893715260,"version":"3.53.1"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T00:00:00Z","timestamp":1599609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Department of Surgery, Western University","award":["RRG-2019"],"award-info":[{"award-number":["RRG-2019"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To characterize the use of common urinary tract infections (UTI)\u2010relevant antibiotics after an SCI and determine the risk of <jats:italic>Clostridium difficile<\/jats:italic> infection (CDI) from these antibiotics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used routinely collected data from Ontario (Canada) to conduct a retrospective, cohort study. We identified people &gt;18 years of age with a traumatic SCI between April 2003 and March 2017. The primary exposure was an outpatient UTI\u2010relevant antibiotic prescription during our observation period, and the primary outcome was evidence of a CDI. An adjusted cox proportional hazards model was used, and antibiotic exposure was modeled as a categorical, time\u2010varying variable based on whether the patient likely had a UTI or not.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 2528 people with SCI; 1642 (65%) were exposed at least once to an antibiotic of interest. The most commonly prescribed UTI\u2010relevant antibiotic was fluoroquinolone (34%). Most patients did not have investigations for a UTI before the\u00a0use of any of the different antibiotic classes. A small number of patients (5%) used chronic (&gt;3 months) UTI\u2010relevant antibiotics. The overall proportion of patients diagnosed with CDI was 7.4% (9.3\/10\u2009000 patient\u2010days). The adjusted hazard ratio for CDI within 30 days was 3.5 (95% confidence interval, 1.9\u20136.7, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01) if they were exposed to a UTI\u2010relevant antibiotic likely associated with a UTI, which was similar to the risk from UTI\u2010relevant antibiotics which may not have been for a UTI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The rate of CDI is high in this population and outpatient antibiotics that are commonly used for UTIs are a significant risk factor for CDI.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.24502","type":"journal-article","created":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T07:50:35Z","timestamp":1600156235000},"page":"2401-2408","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["High risk of <i>Clostridium difficile<\/i> infection among spinal cord injured patients after the use of antibiotics commonly used to 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