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Proton pump inhibitors as a risk factor for paediatric Clostridium difficile infection
Author(s) -
TURCO R.,
MARTINELLI M.,
MIELE E.,
ROSCETTO E.,
DEL PEZZO M.,
GRECO L.,
STAIANO A.
Publication year - 2010
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2009.04229.x
Subject(s) - clostridium difficile , medicine , odds ratio , gastroenterology , c difficile , confidence interval , antibiotics , medical record , proton pump inhibitor , risk factor , clostridium , microbiology and biotechnology , bacteria , biology , genetics
Aliment Pharmacol Ther 31 , 754–759 Summary Background Proton pump inhibitors (PPIs) and H 2 receptor antagonists (H 2 RAs) may play an important role on the onset of Clostridium difficile ‐associated disease (CDAD) in adults. The impact of Clostridium difficile on children treated with gastric acid‐suppressing agents remains unknown. Aim To investigate the relationship between CDAD and exposure to acid suppressive therapy in hospitalized paediatric patients. Methods We reviewed the medical records of children, with a diagnosis of protracted diarrhoea and abdominal pain, whose stool was analysed for C. difficile toxins. We identified 68 patients with CDAD. For each patient, we randomly selected one control subjects with stool analysis negative for C. difficile . Comorbid illnesses, previous hospitalizations, antibiotics, corticosteroids, immunosuppressants and gastric acid suppressing exposures were recorded. Results The use of PPI was significantly higher in C. difficile positive group compared with C. difficile negative group [odds ratio (OR): = 4.5; 95% confidence interval (CI) = 1.4–14.4]. We also found a trend for the use of H 2 RAs in patients infected by C. difficile compared with C. difficile negative comparison group (OR: = 3.8; 95% CI = 0.7–18.9). Conclusions Children exposed to PPIs therapy seem to be at higher risk for the development of Clostridium difficile ‐associated disease.