IngentaConnect Proton pump inhibitor therapy is a risk factor for Clostridium di...

Authors: YEARSLEY, K. A.¹; GILBY, L. J.¹; RAMADAS, A. V.¹; KUBIAK, E. M.²; FONE, D. L.³; ALLISON, M. C.¹

Source: Alimentary Pharmacology & Therapeutics, Volume 24, Number 4, August 2006 , pp. 613-619(7)

Abstract:

Summary Background

Inhibition of gastric acid removes a defence against ingested bacteria and spores, increasing the risk of some forms of gastroenteritis. Previous studies investigating a possible link between acid suppression therapy and Clostridium difficile-associated diarrhoea have reported conflicting results. Aim

To investigate whether acid suppression therapy is associated with an increased risk of C. difficile-associated diarrhoea. Methods

Prospective case-control study of 155 consecutive in-patients with C. difficile-associated diarrhoea. Results

Antibiotics had been received by 143 (92%) of the C. difficile-associated diarrhoea group and 76 (50%) of the controls during the preceding 3 months. Among those receiving antibiotics, 59 (41%) of the C. difficile-associated diarrhoea group had also received acid suppression, compared with 21 (28%) of controls (OR 1.84, CI 1.01, 3.36, χ² = 4.0, P = 0.046). Among the entire C. difficile-associated diarrhoea group 64 (41%) had received acid suppression compared with 40 (26%) of controls (OR 1.99, CI 1.19, 3.31, χ² = 7.9, P = 0.005). Logistic regression analyses found that C. difficile-associated diarrhoea was independently associated with: antibiotic use (OR 13.1, 95% CI: 6.6, 26.1); acid suppression therapy (OR 1.90, 95% CI: 1.10, 3.29); and female sex (OR 1.79, 95% CI: 1.06, 3.04). Conclusions

The risk of C. difficile-associated diarrhoea in hospitalized patients receiving antibiotics may be compounded by exposure to proton pump inhibitor therapy.

Document Type: Research article

DOI: 10.1111/j.1365-2036.2006.03015.x

Affiliations: 1: Adult Medicine 2: Microbiology, Royal Gwent Hospital, Newport, South Wales 3: Department of Epidemiology, Statistics and Public Health, Centre for Health Sciences Research, School of Medicine, Cardiff University, Heath Park, Cardiff, UK

You have access to the full text article on a website external to Ingentaconnect.

Please click here to view this article on InterScience.

You may be required to register and activate access on InterScience before you can obtain the full text. If you have any queries please contact onlinehelp@oxon.blackwellpublishing.com

Proton pump inhibitor therapy is a risk factor for Clostridium difficile-associated diarrhoea