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Background  Healthcare facility-onset  Clostridioides difficile  infection is the leading cause of antibiotic-associated diarrhea, and is associated with morbidity and mortality. The use of antibiotics is an important risk factor for healthcare facility-onset  C. difficile  infection. We evaluated the correlation between the incidence of healthcare facility-onset  C. difficile  infection and antibiotic consumption, according to antibiotic class.    Methods  Patients with healthcare facility-onset  C. difficile  infection from January 2017 to December 2018 at Konkuk University Medical Center (a tertiary medical center) were included. We evaluated changes in the incidence of healthcare facility-onset  C. difficile  infection and antibiotic consumption. The correlation between the incidence of healthcare facility-onset  C. difficile  infection and antibiotic consumption was evaluated two ways: without a time interval and with 1-month interval matching.    Results  A total of 446 episodes of healthcare facility-onset  C. difficile  infection occurred during the study period. The incidence of healthcare facility-onset  C. difficile  infection was 9.3 episodes per 10,000 patient-days, and increased significantly. We observed an increase in the consumption of β-lactam/β-lactamase inhibitors, and a decrease in the consumption of other classes of antibiotics, with a significant decrease in the consumption of fluoroquinolones, glycopeptides, and clindamycin ( P  = 0.01,  P  < 0.001, and  P  = 0.001, respectively). The consumption of β-lactam/β-lactamase inhibitors was independently correlated with the incidence of healthcare facility-onset  C. difficile  infection in the analysis without a time interval. When the analysis was conducted with 1-month interval matching, glycopeptide consumption was independently associated with the incidence of healthcare facility-onset  C. difficile  infection.    Conclusions  Despite the reduction in fluoroquinolone and clindamycin consumption, the incidence of healthcare facility-onset  C. difficile  infection increased during the study period, and was correlated with increased consumption of β-lactam/β-lactamase inhibitors. Reduced consumption of specific antibiotics may be insufficient to reduce the incidence of healthcare facility-onset  C. difficile  infection.    Supplementary Information  The online version contains supplementary material available at 10.1186/s13756-021-00986-9.

antimicrobial resistance and infection control

Correlation between antibiotic consumption and the incidence of healthcare facility-onset Clostridioides difficile infection: a retrospective chart review and analysis