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Effects of proton pump inhibitor use on risk of Clostridium difficile infection: a hospital cohort study

Title
Effects of proton pump inhibitor use on risk of Clostridium difficile infection: a hospital cohort study
Authors
Park, Yoon HeeSeong, Jong MiCho, SoyeonHan, Hye WonKim, Jae YounAn, Sook HeeGwak, Hye Sun
Ewha Authors
곽혜선한혜원성종미
SCOPUS Author ID
곽혜선scopus
Issue Date
2019
Journal Title
JOURNAL OF GASTROENTEROLOGY
ISSN
0944-1174JCR Link

1435-5922JCR Link
Citation
JOURNAL OF GASTROENTEROLOGY vol. 54, no. 12, pp. 1052 - 1060
Keywords
Proton pump inhibitorClostridium difficileDiarrhea
Publisher
SPRINGER JAPAN KK
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
Background Although there are several studies on the association between use of proton pump inhibitors (PPIs) and increased Clostridium difficile infection (CDI) risk, detailed studies analyzing the effects of PPI use on CDI risk are lacking. The present study investigated the association of the dose, duration, and types of PPIs with CDI risk. Methods A single-center, cohort study was conducted on patients admitted to a hospital. The exposed cohort comprised patients who were prescribed PPIs at least once during the study period, and a control cohort was prepared by randomly assigning an index date to patients who did not use PPIs ensuring the same distribution of index dates as in the exposed cohort and matching sex, age, hospitalization period, and date of admission. Results PPI use increased the risk of CDI by 1.8-fold [95% confidence interval (CI) 1.5-2.2]. CDI risk increased by 1.8-fold with esomeprazole (95% CI 1.4-2.2) and 2.0-fold with pantoprazole (95% CI 1.5-2.8). Patients who used a high dose had a higher risk than those who used a medium dose [adjusted hazard ratio (HR) 2.0 vs 1.3]. The risk of CDI increased 4.2-fold when the PPI exposure period was 6 days or shorter than 6 days. Conclusions Our study showed that PPI use was associated with an increased risk of developing CDI and the risk of CDI was dose dependent. Therefore, PPIs should only be used at proper doses and only for the necessary indications to avoid CDI risk.
DOI
10.1007/s00535-019-01598-2
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약학대학 > 약학과 > Journal papers
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