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Proton pump inhibitors are a risk factor for C. difficile reinfection, study finds

Date:
August 10, 2010
Source:
World Journal of Gastroenterology
Summary:
Clostridium-difficile-associated diarrhea (CDAD) is the most common cause of hospital-acquired diarrhea. Although initial response rates to specific antibiotic therapy exceed 90 percent, 10-30 percent of patients experience disease recurrence. Risk factors influence CDAD recurrence are not yet fully understood. A research group in Korea investigated the risk factors for CDAD recurrence. Advanced age, serum albumin levels less than 2.5g/dL and use of PPIs were found to be significant risk factors for CDAD recurrence.

The risk factors for CDAD recurrence have been described as advanced age, severe underlying disease such as renal impairment, multiple episodes of previous CDAD infection, and high white blood cell counts. Recent literature suggests that the use of gastric acid suppressive agents, especially proton pump inhibitors (PPIs) is associated with CDAD recurrence, although results appear to be conflicting.

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A research article to be published on July 28, 2010 in the World Journal of Gastroenterology addresses this question. This research led by Professor Lee from Seoul National University Boramae Hospital investigated the risk factors for CDAD recurrence and the relationship between the use of PPIs and CDAD recurrence. Of the 125 patients that developed CDAD, 98 (78.4%) patients did not experience recurrence and 27 (21.6%) experienced one or more episodes of recurrence.

Age > 65 years, low serum albumin level < 2.5 g/dL, and use of PPIs were found to be risk factors for CDAD recurrence. However, sex, length of hospital stay, duration and type of antibiotics used, severity of disease, leukocyte count and C-reactive protein were not associated with risk of CDAD recurrence.

Of these risk factors, the use of PPIs is a modifiable risk factor, and thus, it is appropriate to review constantly the necessity for concomitant use of PPIs in patients with CDAD. Prevention of unwarranted PPI therapy may be helpful in reducing the risk of CDAD recurrence, and additional larger studies are needed to understand better the relationship between PPI use and CDAD recurrence.


Story Source:

The above story is based on materials provided by World Journal of Gastroenterology. Note: Materials may be edited for content and length.


Journal Reference:

  1. Kim JW, Lee KL, Jeong JB, Kim BG, Shin S, Kim JS, Jung HC, Song IS. Proton pump inhibitors as a risk factor for recurrence of Clostridium-difficile-associated diarrhea. World Journal of Gastroenterology, 2010; 16 (28): 3573 DOI: 10.3748/wjg.v16.i28.3573

Cite This Page:

World Journal of Gastroenterology. "Proton pump inhibitors are a risk factor for C. difficile reinfection, study finds." ScienceDaily. ScienceDaily, 10 August 2010. <www.sciencedaily.com/releases/2010/08/100802091211.htm>.
World Journal of Gastroenterology. (2010, August 10). Proton pump inhibitors are a risk factor for C. difficile reinfection, study finds. ScienceDaily. Retrieved November 28, 2014 from www.sciencedaily.com/releases/2010/08/100802091211.htm
World Journal of Gastroenterology. "Proton pump inhibitors are a risk factor for C. difficile reinfection, study finds." ScienceDaily. www.sciencedaily.com/releases/2010/08/100802091211.htm (accessed November 28, 2014).

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