Abstract
Objective
To evaluate the association of gastric acid suppression medications, including proton
pump inhibitors and histamine type 2 blockers, with outcomes in patients with Clostridium difficile infection (CDI) in a population-based cohort.
Patients and Methods
To understand the association between acid suppression and outcomes in patients with
CDI, we conducted a population-based study in Olmsted County, Minnesota, from January
1, 1991, through December 31, 2005. We compared demographic data and outcomes, including
severe, severe-complicated, and recurrent CDI and treatment failure, in a cohort of
patients with CDI who were treated with acid suppression medications with these outcomes
in a cohort with CDI that was not exposed to acid-suppressing agents.
Results
Of 385 patients with CDI, 36.4% were undergoing acid suppression (23.4% with proton
pump inhibitors, 13.5% with histamine type 2 blockers, and 0.5% with both). On univariate
analysis, patients taking acid suppression medications were significantly older (69
vs 56 years; P<.001) and more likely to have severe (34.2% vs 23.6%; P=.03) or severe-complicated (4.4% vs 2.6% CDI; P=.006) infection than patients not undergoing acid suppression. On multivariable analyses,
after adjustment for age and comorbid conditions, acid suppression medication use
was not associated with severe or severe-complicated CDI. In addition, no association
between acid suppression and treatment failure or CDI recurrence was found.
Conclusion
In this population-based study, after adjustment for age and comorbid conditions,
patients with CDI who underwent acid suppression were not more likely to experience
severe or severe-complicated CDI, treatment failure, or recurrent infection.
Abbreviations and Acronyms:
CDI (Clostridium difficile infection), H2 (histamine type 2), ICD-9 (International Classification of Diseases, Ninth Revision), PPI (proton pump inhibitor), REP (Rochester Epidemiology Project)To read this article in full you will need to make a payment
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Article Info
Footnotes
Grant Support: This research was supported in part by an unrestricted research grant from ViroPharma and by the Rochester Epidemiology Project (grant number R01-AG034676 from the National Institute of Aging ; Principal Investigator: Walter A. Rocca, MD).
Identification
Copyright
© 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
