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Type 2 diabetes patients exhibit higher rates of antibiotic use, infections
Patients with type 2 diabetes were at an increased risk for hospital-treated infections and community-based antibiotic prescriptions compared with the general population, according to study results.
“The rising prevalence of diabetes may contribute to the increasing burden of infection-related hospitalizations and antibiotic overuse worldwide,” Anil Mor, MD, MPH, from the department of clinical epidemiology at Aarhus University Hospital in Denmark, and colleagues wrote.
“With other studies from Europe, the United States and Asia showing significant improvements over time for short- and long-term diabetes treatment targets, the risk of infection in [type 2 diabetes] may have decreased compared with the general population.”
To assess these relationships, the researchers conducted a nationwide cohort study from July 2004 through December 2012 to assess the correlation between patients with type 2 diabetes (n = 155,158) and community-based antibiotic use, as well as hospital-treated infection, compared with individuals without type 2 diabetes (n = 774,017). They enrolled individuals from the Danish National Patient Registry and reviewed glucose-lowering drug prescription records from the Danish National Health Service Prescription Database. The investigators also matched five individuals without diabetes from the general population for each patient with type 2 diabetes, based on age, sex, index date and residence.
The rates of community-based antibiotic prescriptions among patients with type 2 diabetes were 364 per 1,000 person-years vs. 275 per 1,000 person-years among the public after a median follow-up of 1.1 years (adjusted RR = 1.24; 95% CI, 1.23-1.25). Results showed a strong correlation between an increased risk for hospital-treated infections among patients with type 2 diabetes (58 per 1,000 person-years) vs. those without type 2 diabetes (39 per 1,000 person-years) at a median follow-up of 2.8 years (aRR = 1.49; 95% CI, 1.47-1.52).
The researchers observed a decline in 1-year aRR from 1.89 (95% CI, 1.75-2.04) in 2004 to 1.59 (95% CI, 1.45-1.74) in 2011 for hospital-treated infection, and from 1.31 (95% CI, 1.27-1.36) to 1.26 (95% CI, 1.22-1.3) during the same period for antibiotic prescriptions.
“In our study, patients with [type 2 diabetes] experienced higher rates of both community antibiotic prescriptions and hospital-treated infections than matched members of the general population comparison cohort,” the investigators wrote. “The RRs were particularly high for severe infections and for hospitalizations and treatments related to [urinary tract infections] and skin infections.” – by Kate Sherrer
Disclosure: Mor reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.