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Proton Pump Inhibitors and Risk for Recurrent Clostridium difficileInfection

Proton Pump Inhibitors and Risk for Recurrent Clostridium difficileInfection ORIGINAL INVESTIGATION LESS IS MORE Proton Pump Inhibitors and Risk for Recurrent Clostridium difficile Infection Amy Linsky, MD; Kalpana Gupta, MD, MPH; Elizabeth V. Lawler, DSc; Jennifer R. Fonda, MA; John A. Hermos, MD Background: Proton pump inhibitors (PPIs) are widely Results:RecurrentCDIwasmorecommoninthoseexposed used gastric acid suppressants, but they are often pre- to PPIs than in those not exposed (25.2% vs 18.5%). Using scribed without clear indications and may increase risk Coxproportionalsurvivalmethods,wedeterminedthatthe of Clostridium difficile infection (CDI). We sought to de- adjusted HR of recurrent CDI was greater in those exposed termine the association between PPI use and the risk of to PPIs during treatment (1.42; 95% confidence interval recurrent CDI. [CI], 1.11-1.82). Risks among exposed patients were high- est among those older than 80 years (HR, 1.86; 95% CI, Methods: Retrospective, cohort study using adminis- 1.15-3.01) and those receiving antibiotics not targeted to trative databases of the New England Veterans Health- C difficile during follow-up (HR, 1.71; 95% CI, 1.11-1.64). care System from October 1, 2003, through September 30, 2008. We identified 1166 inpatients and outpatients Conclusions: Proton pump inhibitor use during inci- with metronidazole- or vancomycin hydrochloride– dent CDI treatment was associated with a 42% increased treated incident http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

Proton Pump Inhibitors and Risk for Recurrent Clostridium difficileInfection

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References (66)

Publisher
American Medical Association
Copyright
Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/archinternmed.2010.73
pmid
20458084
Publisher site
See Article on Publisher Site

Abstract

ORIGINAL INVESTIGATION LESS IS MORE Proton Pump Inhibitors and Risk for Recurrent Clostridium difficile Infection Amy Linsky, MD; Kalpana Gupta, MD, MPH; Elizabeth V. Lawler, DSc; Jennifer R. Fonda, MA; John A. Hermos, MD Background: Proton pump inhibitors (PPIs) are widely Results:RecurrentCDIwasmorecommoninthoseexposed used gastric acid suppressants, but they are often pre- to PPIs than in those not exposed (25.2% vs 18.5%). Using scribed without clear indications and may increase risk Coxproportionalsurvivalmethods,wedeterminedthatthe of Clostridium difficile infection (CDI). We sought to de- adjusted HR of recurrent CDI was greater in those exposed termine the association between PPI use and the risk of to PPIs during treatment (1.42; 95% confidence interval recurrent CDI. [CI], 1.11-1.82). Risks among exposed patients were high- est among those older than 80 years (HR, 1.86; 95% CI, Methods: Retrospective, cohort study using adminis- 1.15-3.01) and those receiving antibiotics not targeted to trative databases of the New England Veterans Health- C difficile during follow-up (HR, 1.71; 95% CI, 1.11-1.64). care System from October 1, 2003, through September 30, 2008. We identified 1166 inpatients and outpatients Conclusions: Proton pump inhibitor use during inci- with metronidazole- or vancomycin hydrochloride– dent CDI treatment was associated with a 42% increased treated incident

Journal

JAMA Internal Medicine – American Medical Association

Published: May 10, 2010

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