Ronald L. Koretz, MD
Are proton-pump inhibitors (PPIs) associated with increased risk for Clostridium difficile infection?
Included studies compared PPI exposure with no PPI exposure and measured Clostridium difficile infection.
MEDLINE and EMBASE/Excerpta Medica (to Dec 2011), reference lists of included studies, and recent reviews were searched for controlled observational studies that presented odds ratios or risk ratios, or sufficient data to calculate odds ratios or risk ratios. 12 cohort studies and 30 case–control studies (n = 313 000, mean age 9 to 82 y, 16% to 99% men, where reported) met the selection criteria. None of the studies were at low risk for bias.
Meta-analysis showed that PPI exposure was associated with greater risk for incident and recurrent Clostridium difficile infection (Table). Significant statistical heterogeneity existed across study results for all reported outcomes (I2 = 75% to 97%).
Use of proton-pump inhibitors is associated with increased risk for Clostridium difficile infection.
Association between proton-pump inhibitors and Clostridium difficile infection (CDI)*
*CI defined in Glossary.
Koretz RL. Review: Proton-pump inhibitors are associated with increased risk for Clostridium difficile infection. Ann Intern Med. ;157:JC2–13. doi: 10.7326/0003-4819-157-4-201208210-02013
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Published: Ann Intern Med. 2012;157(4):JC2-13.
Gastroenterology/Hepatology, Hospital Medicine, Infectious Disease.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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