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

被引:122
作者
Yearsley, K. A.
Gilby, L. J. .
Ramadas, A. V.
Kubiak, E. M.
Fone, D. L.
Allison, M. C. [1 ]
机构
[1] Royal Gwent Hosp, Dept Adult Med, Newport NP20 2UB, Gwent, Wales
[2] Royal Gwent Hosp, Dept Microbiol, Newport NP20 2UB, Gwent, Wales
[3] Cardiff Univ, Dept Epidemiol Stat & Publ Hlth, Ctr Hlth Sci Res, Sch Med, Cardiff, Wales
关键词
D O I
10.1111/j.1365-2036.2006.03015.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
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, chi(2) = 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, chi(2) = 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.
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页码:613 / 619
页数:7
相关论文
共 39 条
  • [1] Al-Eidan FA, 2000, J CLIN PHARM THER, V25, P101
  • [2] Archimandritis A, 1998, J INTERN MED, V243, P251
  • [3] Epidemiology of Clostridium difficile-associated infections
    Barbut, F
    Petit, JC
    [J]. CLINICAL MICROBIOLOGY AND INFECTION, 2001, 7 (08) : 405 - 410
  • [4] Risk factors for Clostridium difficile infection
    Bignardi, GE
    [J]. JOURNAL OF HOSPITAL INFECTION, 1998, 40 (01) : 1 - 15
  • [5] ISOLATION OF CLOSTRIDIUM-DIFFICILE AT A UNIVERSITY HOSPITAL - A 2-YEAR STUDY
    BOWEN, KE
    MCFARLAND, LV
    GREENBERG, RN
    RAMSEY, MM
    RECORD, KE
    SVENSON, J
    [J]. CLINICAL INFECTIOUS DISEASES, 1995, 20 : S261 - S262
  • [7] Proton pump inhibitors as a risk factor for Clostridium difficile diarrhoea
    Cunningham, R
    Dale, B
    Undy, B
    Gaunt, N
    [J]. JOURNAL OF HOSPITAL INFECTION, 2003, 54 (03) : 243 - 245
  • [8] Delayed postprandial gastric emptying and impaired gallbladder contraction together with elevated cholecystokinin and peptide YY serum levels sustain satiety and inhibit hunger in healthy elderly persons
    Di Francesco, V
    Zamboni, M
    Dioli, A
    Zoico, E
    Mazzali, G
    Omizzolo, F
    Bissoli, L
    Solerte, SB
    Benini, L
    Bosello, O
    [J]. JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, 2005, 60 (12): : 1581 - 1585
  • [9] Use of gastric acid-suppressive agents and the risk of community-acquired Clostridium difficile-associated disease
    Dial, S
    Delaney, JAC
    Barkun, AN
    Suissa, S
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2005, 294 (23): : 2989 - 2995
  • [10] Risk of Clostridium difficile diarrhea among hospital inpatients prescribed proton pump inhibitors:: cohort and case-control studies
    Dial, S
    Alrasadi, K
    Manoukian, C
    Huang, A
    Menzies, D
    [J]. CANADIAN MEDICAL ASSOCIATION JOURNAL, 2004, 171 (01) : 33 - 38