Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

PPIs and risk for recurrent Clostridium difficile infection among inpatients

The most recent issue of the American Journal of Gastroenterology examines the association between PPI use and risk of recurrent C.difficile infection among inpatients.

News image

Observational studies suggest that proton pump inhibitors (PPIs) are a risk factor for incident Clostridium difficile infection (CDI).

Data also suggest an association between PPIs and recurrent CDI, although large-scale studies focusing solely on hospitalized patients are lacking.

Dr Daniel Freedberg and colleagues therefore performed a retrospective cohort analysis of inpatients with incident CDI to assess receipt of PPIs as a risk factor for CDI recurrence in this population.

Using electronic medical records, the team identified hospitalized adult patients between 2009 and 2012 with incident CDI, defined as a first positive stool test for C. difficile toxin B and who received appropriate treatment.

Electronic records were parsed for clinical factors including receipt of PPIs, other acid suppression, non-CDI antibiotics, and comorbidities.

The team's primary exposure was in-hospital PPIs given concurrently with C. difficile treatment.

The cumulative incidence of CDI recurrence in the cohort was 23%
American Journal of Gastroenterology

Recurrence was defined as a second positive stool test 15–90 days after the initial positive test.

The team found that the C. difficile recurrence rates in the PPI exposed and unexposed groups were compared with the log-rank test.

Multivariable Cox proportional hazards modeling was performed to control for demographics, comorbidities, and other clinical factors.

The research team identified 894 inpatients with incident CDI.

The cumulative incidence of CDI recurrence in the cohort was 23%.

The researchers found that receipt of PPIs concurrent with CDI treatment was not associated with C. difficile recurrence.

Black race, increased age, and increased comorbidities were associated with CDI recurrence.

In light of a higher 90-day mortality seen among those who received PPIs, the team also analyzed the subset of patients who survived to 90 days of follow-up.

The team observed no association between PPIs and CDI recurrence.

The researchers found no association between recurrent CDI and increased duration or dose of PPIs.

Dr Freedberg's team concludes, "Among hospitalized adults with C. difficile, receipt of PPIs concurrent with C. difficile treatment was not associated with CDI recurrence."

"Black race, increased age, and increased comorbidities significantly predicted recurrence. Future studies should test interventions to prevent CDI recurrence among high-risk inpatients."

Am J Gastroenterol 2014: 108: 1794-1801
19 December 2013

Go to top of page Email this page Email this page to a colleague

 31 March 2015

Advanced search
 31 March 2015 
HCV-HIV co-infection combination therapy
 31 March 2015 
Placement of nasoenteral feeding tubes
 31 March 2015 
Hepatic fat and gallbladder polyps
 30 March 2015 
Minimally invasive approach in colorectal procedures
 30 March 2015 
Prevalence of IBD in USA residents of Indian ancestry
 30 March 2015 
Treatment of pediatric IBD
 27 March 2015 
Screening for fecal incontinence
 27 March 2015 
Deep remission in Crohn's disease
 27 March 2015 
Sexual functioning in IBD
 26 March 2015 
Antimicrobial therapy in cirrhosis with spontaneous bacterial peritonitis
 26 March 2015 
Metformin as a chemopreventive agent for Barrett's
 26 March 2015 
Survival of untreated hepatocellular carcinoma
 25 March 2015 
Genetics and Crohn's disease
 25 March 2015 
Mortality in Barrett’s–related T1 esophageal adenocarcinoma
 25 March 2015 
Cytomegalovirus and IBD
 24 March 2015 
Prevention of colorectal cancer after screening
 24 March 2015 
Functional GI disorders and body mass index
 24 March 2015 
Quality of life in children with fecal incontinence
 23 March 2015 
Fibrosis in NAFLD vs NASH
 23 March 2015 
The unmasking of Whipple's disease
 23 March 2015 
Predicting the quality of colon cancer care
 20 March 2015 
Interventions for eosinophilic esophagitis
 20 March 2015 
Screening for Barrett's esophagus
 20 March 2015 
Colorectal cancer risk and genetic variants
 19 March 2015 
Dedicated care for diverticular disease
 19 March 2015 
Hypnotherapy for IBS
 19 March 2015 
Poor mental and physical health in HCV
 18 March 2015 
Practice guidelines for colorectal polyps
 18 March 2015 
Out-of-hours endoscopy for upper GI bleeding
 18 March 2015 
H. pylori eradication and lipids
 17 March 2015 
H. pylori test-and-treat program and gastric cancer
 17 March 2015 
Adalimumab in Crohn’s disease
 17 March 2015 

Low-dose PPIs and GI bleeding in patients receiving aspirin

 16 March 2015 
Microscopic colitis
 16 March 2015 
Cholestasis of pregnancy with HCV
 16 March 2015 
Hybrid therapy for H. pylori
 13 March 2015 
Medicare patients and payments to gastroenterologists
 13 March 2015 
Appendectomy in ulcerative colitis
 13 March 2015 

Racial disparities in gluten-sensitive problems

 12 March 2015 
Predicting IBD in IBS patients
 12 March 2015 
Patient knowledge of IBS
 12 March 2015 
Nonceliac gluten sensitivity
 11 March 2015 

Prediction of malignant bile duct obstruction

 11 March 2015 
NAFLD–related hepatocellular carcinoma
 11 March 2015 
Assessment of eosinophilic esophagitis
 10 March 2015 
Risk for gastroesophageal reflux symptoms
 10 March 2015 
Poor disease course in pediatric ulcerative colitis
 10 March 2015 
Outcomes in Crohn's therapy
 09 March 2015 
Fibre usage in ulcerative colitis in remission
 09 March 2015 
Risk of C. difficile upon hospital admission
 09 March 2015 
Gastric Cancer detection during GI endosocopy
 06 March 2015 
Steroid therapy for eosinophilic esophagitis
 06 March 2015 
Second anti-TNF in IBD
 06 March 2015 
Efficacy of Hep E vaccine
 05 March 2015 
EPHXI polymorphism and esophageal cancer risk
 05 March 2015 
Infliximab and immunosuppressant therapy in ulcerative colitis
 05 March 2015 
Neuroendocrine carcinoma of the colon and rectum
 04 March 2015 
Multidisciplinary management of rectal cancer
 04 March 2015 
Management of IBD
 04 March 2015 
Progression of Barrett's

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us