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 1590 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

 03 September 2015

Advanced search
 03 September 2015 
Factors that influence GI transit with the wireless motility capsule
 03 September 2015 
Antibiotic resistance of H. pylori
 03 September 2015 
NAFLD in adolescents undergoing bariatric surgery
 02 September 2015 
Anxiety and functional dyspepsia
 02 September 2015 
Cancer predisposition genes in suspected Lynch syndrome
 02 September 2015 
Adherence to a gluten-free diet in celiac disease
 01 September 2015 
Nonceliac wheat sensitivity and autoimmune disease
 01 September 2015 
Dysphagia after antireflux surgery
 01 September 2015 
Predict treatment success in ulcerative colitis
 31 August 2015 

Fecal microbiota transplantation in IBD

 31 August 2015 
Probiotics and liver transplantation
 31 August 2015 
Cancer incidence in Barrett's
 28 August 2015 
Statin use and survival in pancreatic cancer
 28 August 2015 
Bacterial endotoxin and NAFLD
 28 August 2015 
Interferon-free regimens for Hep C
 27 August 2015 
HCV in Egypt
 27 August 2015 
Liver abnormalities in celiac disease
 27 August 2015 
Gene expression for hepatocellular carcinoma
 26 August 2015 
Medical management of diverticular disease
 26 August 2015 
Treatment of erosive esophagitis
 26 August 2015 
Dermatological complications of anti-TNF therapy in IBD
 25 August 2015 
Markers for colorectal cancer screening
 25 August 2015 
Long-term PPI use and serum gastrin levels
 25 August 2015 
Treatment for HCV and HIV-1 co-infection
 24 August 2015 
Treatment for HCV and HIV-1 co-infection
 24 August 2015 
Cirrhosis in Hepatitis C patients
 24 August 2015 
Aspirin use and colorectal cancer survival
 21 August 2015 
Activity indexes in ulcerative colitis
 21 August 2015 
Coffee and gallstone disease
 21 August 2015 
Alcoholic cirrhosis in relapse after liver transplant
 20 August 2015 
Cirrhosis in the USA
 20 August 2015 
Mortality causes in liver cirrhosis
 20 August 2015 
Risk of death in IBD
 19 August 2015 
Predicting intestinal surgery in Crohn's disease
 19 August 2015 
Sleep positioning device reduces reflux
 19 August 2015 
Improved screening colonoscopy quality
 18 August 2015 
Health insurance influences HCV screening outcomes
 18 August 2015 
Somatostatin analogues in polycystic liver disease
 18 August 2015 
Global consensus report on H. pylori gastritis
 17 August 2015 
Biomarker of fibrosis stage in NAFLD
 17 August 2015 
Prognostic score for primary biliary cirrhosis
 17 August 2015 
Measuring subjective health in patients with IBS
 14 August 2015 
Factors that influence ulcerative colitis procedure type
 14 August 2015 
H. pylori in African American and Hispanic veterans
 14 August 2015 
Hep E virus in decompensated chronic liver disease
 13 August 2015 
H. pylori in drinking water
 13 August 2015 
Sofosbuvir-regimens in HCV
 13 August 2015 
IBS among Japanese adolescents
 12 August 2015 
Infliximab in patients in IBD
 12 August 2015 
Predictors of severity of IBD
 12 August 2015 
Peritoneal carcinomatosis in colorectal cancer
 11 August 2015 
Chemotherapy and intestinal microbiomes
 11 August 2015 
H. pylori and immune thrombocytopenic purpura
 11 August 2015 
Sexual dysfunction after rectal cancer treatment
 10 August 2015 
Predicting lymph node metastasis in T1 colorectal cancer
 10 August 2015 
Scoring systems to predict alcoholic hepatitis outcomes
 10 August 2015 
Sofosbuvir-based regimens in veterans with HCV
 07 August 2015 
Factors associated with changes in ulcerative colitis
 07 August 2015 
Bariatric surgery and NASH in obese patients
 07 August 2015 
Caffeine and fibrosis in Hep C

Blackwell Publishing


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