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Clostridium difficile–associated disease (CDAD) represents a substantial and increasing cause of morbidity, mortality, and health care spending.1 A primary risk factor for CDAD is systemic antibiotic use; disruption of normal gastrointestinal flora is thought to limit resistance to colonization by pathogenic bacteria including C difficile, resulting in potentially serious antibiotic-associated diarrhea. Whereas individuals often contract CDAD as a hospital-acquired infection, increasing numbers of community-acquired CDAD cases are being recognized.2 Limited data on community-acquired CDAD point to several antibiotics—particularly clindamycin, but also β-lactam antibiotics, fluoroquinolones, and macrolides—whose use may pose a risk.3
Nambudiri VE, Bigby ME. Practicing Prevention With Probiotics. JAMA Dermatol. 2013;149(12):1422-1424. doi:10.1001/jamadermatol.2013.6226