A Retrospective Analysis of the Incidence of Clostridium Difficile Associated Diarrhea with Meropenem and Piperacillin-tazobactam
Bibliographic record
Abstract
Introduction: Meropenem and piperacillin-tazobactam have similar indications, spectrum of antimicrobial actions, and cost. When selecting between two antibiotics with similar efficacy, one may want the antibiotic with the least harm, such as C. difficile associated diarrhea (CDAD). Aim & Objectives: This study tested the hypothesis that patients on piperacillintazobactam had a lower incidence of CDAD than patients on meropenem. Methods: A retrospective analysis was performed that included patients who received meropenem or piperacillin-tazobactam during their admissions to Ridge Meadows Hospital, Canada from September 2007 to August 2009. This study had a subgroup analysis on patients with risk factors of developing CDAD: male, over 65 years old, staying longer than 28 days in healthcare settings, receiving concurrent risk factor medications, not on Saccharomyces boulardii in the previous two months, and not on oral metronidazole, intravenous metronidazole, or oral vancomycin in the previous two months. Results: There were 168 patients in the meropenem group and 122 patients in the piperacillin-tazobactam group. No significant difference was found between meropenem and piperacillin-tazobactam with respect to incidence of CDAD (3.57% and 4.92%, respectively; p=0.5676), two-month in-hospital mortality (34.52% and 36.89%, respectively; p=0.7102), and composite outcome of CDAD and two-month in-hospital mortality (37.50% and 40.16%, respectively; p=0.7142). All subgroup analyses showed no difference in incidence of CDAD between the two antibiotics. Conclusions: There was no evidence to support patients on piperacillin-tazobactam had a lower incidence of CDAD or mortality than patients on meropenem. Further research is still needed to help selecting the safest antibiotic for patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".