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Proton pump inhibitors and risk of Clostridium difficile infection: a multi-country study using sequence symmetry analysis
- Proton pump inhibitors and risk of Clostridium difficile infection: a multi-country study using sequence symmetry analysis
- Roughead, Elizabeth E.; Chan, Esther W.; Choi, Nam-Kyong; Griffiths, Jenna; Jin, Xue-Mei; Lee, Joongyub; Kimura, Michio; Kimura, Tomomi; Kubota, Kiyoshi; Lai, Edward Chia-Cheng; Man, Kenneth K. C.; Tuan Anh Nguyen; Ooba, Nobuhiro; Park, Byung-Joo; Sato, Tsugumichi; Shin, Ju-Young; Wang, TongTong; Wong, Ian C. K.; Yang, Yea-Huei Kao; Pratt, Nicole L.
- Ewha Authors
- Issue Date
- Journal Title
- EXPERT OPINION ON DRUG SAFETY
- EXPERT OPINION ON DRUG SAFETY vol. 15, no. 12, pp. 1589 - 1595
- Proton pump inhibitors; Clostridium difficile; adverse event; Asia; sequence symmetry analysis
- TAYLOR &
- SCIE; SCOPUS
- Document Type
- Objective: To determine the association between incident proton pump inhibitor (PPI) use and Clostridium difficile infections across multiple countries Method: National data covering the total population in Australia and Korea, the Canadian population over 65 years and a 3 million person random sample data set from Taiwan were assessed, as were data from a worker insurance population and a hospital inpatient/outpatient population in Japan. Sequence symmetry analysis was used to assess the association with oral vancomycin dispensing as the outcome of interest. Results: 54,957 patients were included. Positive associations were observed in Australia; adjusted sequence ratio (ASR) 2.48 (95% CI 1.90, 3.12), Korea ASR 2.15 (95% CI 2.11, 2.19), Canada ASR 1.45 (95% CI 1.16, 1.79), Japan hospital dataset ASR 3.21 (95% CI 2.12, 4.55) and Japan worker insurance dataset ASR 5.40 (95% CI 2.73, 8.75). The pooled result was ASR 2.40 (95% CI 1.88, 3.05) and 3.16 (95% CI 1.95, 5.10) when limited to Japan, Korean and Taiwan. Results did not vary by individual PPI. The temporal analysis showed effects within the first two weeks of PPI initiation. Conclusion: Our study confirms the association between PPI initiation and C. difficile infections across countries in the Asia-Pacific region.
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