Meta-analysiscited by the Tayebat archiveabstract only checked A-ABX-12 standard review
Antibiotics and C. difficile
Meta-analysis of antibiotics and the risk of community-associated Clostridium difficile infection.
Overview
Brown KA et al.. Antimicrob Agents Chemother 2013 · PMID 23478961 · DOI 10.1128/AAC.02176-12
Some antibiotics (e.g. clindamycin) strongly raise C. difficile risk; tetracyclines did not.
Does the study support the specific claim? Yes · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Compare classes.
- How was the study done?
Meta-analysis.
- How many people, animals or samples were studied?
7 studies.
- What was actually found?
Varies by class.
- How large was the observed effect?
OR up to 16.8.
- What do the results mean in everyday life?
Choose antibiotics carefully.
- What are the study's limitations?
Few studies.
- What does it say about Elawady's specific claim?
Supports.
- Do the results apply to Germany and Europe?
High.
Scientific in-depth review
1. Full reference
- Authors
- Brown KA, Khanafer N, Daneman N, Fisman DN
- Journal
- Antimicrob Agents Chemother
- Year
- 2013
- Identifier
- PMID 23478961 DOI 10.1128/AAC.02176-12 · PMC3632900
- Verification
- verified – PubMed E-utilities efetch, 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract/record (grants: Canadian Institutes of Health Research)
2. Research question
Antibiotic class and community-associated C. difficile
3. Study design and population
- Study design
- Meta-analysis – Meta-analysis of 7 observational studies
- Population
Non-hospitalised
- Country
Multinational
- Period
to 2013
- Sample size
7 studies
- Inclusion and exclusion criteria
Comparative studies, community
4. Methods and endpoints
- Exposure / intervention
Antibiotic classes
- Comparator
No antibiotics
- Endpoints
CDI
- Statistical methods
Random effects
5. Actual results
- Results
Clindamycin OR 16.80; fluoroquinolones 5.50; CMCs 5.68; macrolides 2.65; penicillins 2.71; tetracyclines 0.92 (ns).
- Absolute risks
not reported
- Authors' conclusion
Avoid high-risk antibiotics.
6. Strengths
- Class comparison
7. Weaknesses
- Few studies
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
9. Assessment of the statistical interpretation
10. Relevance to the specific claim
11. Independent contrary findings
12. Transferability to Germany and Europe
High.
13. Overall methodological judgement
Well-established harm.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | low |
| Directness | direct |
| Reproducibility | replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
15. Linked fact checks
Use by the Tayebat archive
Note: according to the archive, the studies were compiled by the archive operators. Whether Dr. Elawady himself cited this study is not established.
- What the archive says about the study
Bibliography only.
- A. What was actually studied?
CDI risk.
- B. What did the authors find?
Class-specific risk.
- C. What conclusions do the authors themselves draw?
Avoid high-risk classes.
- D. What does the archive derive from it?
Harm of antibiotics.
- E. Is this derivation scientifically justified?
Justified (drug choice).
- Adequacy of the interpretation (by the archive)
- not applicable