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• W2541363886 abstract "We read with great interest the article published by Gordon and colleagues in the Journal (February 2016) which attempted to identify the associated risk of Clostridium difficile infection (CDI) in patients receiving proton pump inhibitors (PPIs). 1 Gordon D. Young L.R. Reddy S. Bergman C. Young J.D. Incidence of Clostridium difficile infection in patients receiving high-risk antibiotics with or without a proton pump inhibitor. J Hosp Infect. 2016; 92: 173-177 Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar The authors concluded that those receiving a PPI were more than twice as likely to develop CDI compared to those who did not receive a PPI. The authors should be commended for this study particularly due to their unique ability to collect reliable data in both inpatient and outpatient settings and for exploring an issue that has, for quite some time, been controversial. However, there are several important limitations that need to be discussed. First, Table I describes the demographics and lists the sample sizes as 3513 and 6149 patients in the PPI and non-PPI groups, respectively. None of the listed demographics in Table I were calculated as being significantly different between groups. In a study of this size, we would expect differences such as these (e.g. 6.5% vs 2.0% of patients received chemotherapy, listed as P=0.38) to be statistically significant. Further examination of Table I reveals that these data are tabulated only from patients diagnosed with CDI (62 and 49 patients, respectively) rather than from the whole study sample (3513 and 6149 patients). If the demographics listed in the table did in fact represent the entire sample of the study as indicated, then all of the demographics listed would reach statistical significance (e.g. approximately 228/3513 vs 123/6149 of patients receiving chemotherapy, which we calculate to be P<0.0001). Whereas this appears to be a minor typographical error (listing the wrong number of patients in the table), from these data the authors conclude that the groups are similar. We conclude conversely that the groups are indeed different but that significance was not achieved due to lack of statistical power." @default.
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• W2541363886 date "2017-04-01" @default.
• W2541363886 modified "2023-09-25" @default.
• W2541363886 title "Are proton pump inhibitors associated with an increased risk of Clostridium difficile infection after considering confounding variables?" @default.
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• W2541363886 doi "https://doi.org/10.1016/j.jhin.2016.10.016" @default.
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