Tariq R, et al. - A systematic review and meta-analysis of studies was conducted to assess the risk of Clostridium difficile infection (CDI) with tetracyclines compared with the risk with other antibiotics. Findings suggested a decreased risk of CDI with tetracyclines administration in comparison to other antimicrobials. Whenever appropriate, it could be reasonable to use tetracyclines to decrease the burden of future CDI associated with antibiotic use.

Methods

• A systematic search was undertaken of MEDLINE, Embase, and Web of Science from January 1978 through December 2016 to include studies assessing the association between tetracycline use and risk of CDI.
• Researchers assessed the weighted summary estimates using generalized inverse variance with a random-effects model using RevMan 5.3.
• They assessed study quality using the Newcastle-Ottawa scale.

Results

• From 1993 to 2012, researchers included six studies (4 case-control, 2 cohort) with patient recruitment.
• Meta-analysis of these studies using the random-effects model suggested that tetracycline use was associated with a decreased risk of CDI (odds ratio, 0.62; 95% CI, 0.47–0.81; P<.001).
• Significant heterogeneity was revealed among the studies, with an I² of 53%.
• There appeared no publication bias.
• Subgroup analysis of studies evaluating the risk of CDI with doxycycline alone also indicated a decreased risk of CDI (odds ratio, 0.55; 95% CI, 0.40–0.75; P<.001).