While antibiotics are the most common medications for causing clostridium difficile (CDI) infections, several recent studies have also linked an increased risk of CDI to the use of a proton pump inhibitor (PPI).
A team, led by Dania Tawam, Fairleigh Dickinson University School of Medicine and Health Sciences, reviewed and summarized all available routine data examining the link and risk between PPI use and risk. diseases C diff.
The link between medication and C Diff
Because they are abundant as an over-the-counter medication and are often prescribed by physicians to reduce and alleviate symptoms of diseases such as gastroesophageal reflux disease, proton pump protectors are among the most common medications.
However, the U.S. Food and Drug Administration (FDA) has issued a warning for the use of PPI regarding the risk of developing CDI.
The Literature Review
The researchers examined relevant studies using proton pump protectors, PPI, Clostridium difficile, or C diff as research terms.
In total, they found 8 meta-analyzes and systematic reviews that met their inclusion criteria, including studies conducted in the US, Europe, Asia, and Canada on adults inpatient and outpatient.
The 8 studies showed a statistically significant association between drug use and C diff diseases. These diseases ranged from moderate to high risk.
“Currently available data show a positive association between PPIs and CDIs,” the authors wrote.
Recent study
Researchers recently found that an increased risk for C diff infection increased for up to a year after discontinuing treatment with proton pump inhibitors.
Researchers from Copenhagen, Denmark used a national group of adults with C diff disease to compare times with and without knowledge of PPIs.
All adults were treated between February 2010 and December 2013.
Eventually, the authors of the study identified 3583 cases of C diff infection found in the community, 964 of which occurred when PPI was currently being used.
Of the infections that occurred using PPIs, 324 occurred within 0–6 months after treatment decision. In addition, 123 cases occurred between 6 and 12 months after cessation of treatment.
The remaining C diff infection cases occurred during periods without the use of PPIs, the investigators said.
Comparing the use of PPIs with non-use, the study authors found that the estimated variable frequency ratio (IRR) ratio was 2.03, they said. But the increased risk also remained at later times as well: 1.54 for 0-6 months, and 1.24 for 6-12 months.
One limitation provided by the study authors was that it had its original characteristics C diff the disease could be misdiagnosed and patients prescribed PPI could not be excluded.
However, they also acknowledged, “this is unlikely to lead to biased results due to the symptoms at C diff infectivity (diarrhea) differs from the highest gastrointestinal symptoms which represents the most common symptom for PPIs. ”
The study, “The Positive Association between Proton Pump Inhibitors and Clostridium Difficile Disease,” was published online in Innovations in Pharmacy.