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• W1997366107 abstract "Mary Ann Moon is a freelance writer based in Clarksburg, Md. Use of proton pump inhibitors appears to increase the risk of recurrent Clostridium difficile infection and may even have a causal effect, according to two cohort studies. In the first, PPI use during treatment of an incident C. difficile infection was associated with a 42% higher risk of recurrent infection. The second study demonstrated a dose-response effect between increasing acid suppression and nosocomial C. difficile infection. Neither study was designed to definitively establish causality: An adequately sized randomized controlled trial would be prohibitively expensive and possibly unethical. But findings from both studies should prompt clinicians to limit patients' exposure to PPI therapy, both groups of investigators naid. In the first study, Amy Linsky, MD, of Boston Medical Center and her associates identified 1,166 patients who began treatment for C. difficile during a 4-year period. This included 527 patients (45%) who used an oral PPI at some time during the 14 days following diagnosis, and 639 (55%) who did not. The primary end point was recurrent C. difficile infection during the 90 days following the incident diagnosis. This occurred in 25% of the PPI-exposed group, compared with 19% of the unexposed group. After data adjustment, the hazard ratio for PPI exposure ras 1.42. Arch. Intern. Med. 2010;170:772-8). In the second study, Michael D. Howell, MD, of Beth Israel Deaconess Medical Center, Boston, and his associates performed a secondary analysis of data prospectively collected on 101,796 discharges from their center in 2004-2008. Nosocomial C. difficile infection had developed in 665 (0.7%) of these cases. In unadjusted analysis, the risk of acquiring the infection rose from 0.3% with no exposure to PPIs to 0.9% with daily use of PPIs to 1.4% with more frequent than daily use of PPIs. There was a greater than 70% increase in the risk of developing nosocomial C. difficile if a patientiwas taking a daily PPI, and more than a doubling of the odds if a patientisas taking a PPI more frequently, the investigators said (Arch. Intern. Med. 2010;170:784-90). The findings suggest that “we should expect at least 1 additional case of nosocomial C. difficile infection for every 533 patients who receive a daily PPI, after controlling for other risk factors,” Dr. Howell and associates noted." @default.
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• W1997366107 date "2010-07-01" @default.
• W1997366107 modified "2023-10-14" @default.
• W1997366107 title "Infection Link to Proton Pump Inhibitors Bolstered" @default.
• W1997366107 doi "https://doi.org/10.1016/s1526-4114(10)60177-1" @default.
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