Combined Use of Antibiotics as a Risk Factor for Health Care–Associated Infections: A Case-Control Study

Abstract BackgroundAntibiotics are among the most frequently prescribed medications. Many studies suggest an increased risk of health care–associated infections (HAIs) among antibiotic users. However，most related studies have focused only on a single type of HAIs, but considering the complexity and extent of the subject, it is necessary to conduct extensive research. We conducted a case-control study to determine the association between antibiotic combination therapy and risk of HAIs. MethodsRetrospective case-control study in a teaching hospital in Northwest China. Cases of 216 patients were diagnosed as HAIs during hospitalization between January 2019 and December 2019. Use antibiotics on admission and before the occurrence of HAIs were compared with 428 patients without HAIs during the same period, and matched by department.ResultsNinety-one of 216 health care–associated infections, 157 of 428 Patients without health care–associated infections prescribed antibiotics on admission and before the occurrence of HAIs. After multi-variable analysis, Compared with patients without HAIs, the OR for antibiotics combination exposure in cases was 5.43 [95% confidence interval (CI) 2.62-11.24], and the OR for antibiotics exposure in cases was 0.23 (95% CI 0.12-0.43).ConclusionsCombined use of antibiotics increases the risk of HAIs. In addition, Use of antibiotics before the diagnosis of HAIs is conducted associated with HAIs, and is the main protective factor.