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Proton-Pump Inhibit...
Proton-Pump Inhibitor Use and the Risk of Community-Associated Clostridium difficile Infection
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- Inghammar, Malin (author)
- Lund University,Lunds universitet,Infektionsmedicin,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Infection Medicine (BMC),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Danish Serum Institute, Copenhagen
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- Svanström, Henrik (author)
- Karolinska Institutet,Karolinska Institute,Danish Serum Institute, Copenhagen
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- Voldstedlund, Marianne (author)
- Danish Serum Institute, Copenhagen
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- Melbye, Mads (author)
- University of Copenhagen,Danish Serum Institute, Copenhagen,Stanford University
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- Hviid, Anders (author)
- Danish Serum Institute, Copenhagen
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- Mølbak, Kåre (author)
- Danish Serum Institute, Copenhagen,University of Copenhagen
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- Pasternak, Björn (author)
- Karolinska Institutet,Karolinska Institute,Danish Serum Institute, Copenhagen
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(creator_code:org_t)
- 2021-02-25
- 2021
- English.
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In: Clinical Infectious Diseases. - : Oxford University Press (OUP). - 1058-4838 .- 1537-6591. ; 72:12, s. 1084-1089
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Abstract
Subject headings
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- Background: Proton-pump inhibitors (PPIs) have been reported to increase the risk of community-associated Clostridium difficile infection (CDI), but the association remains disputed. Methods: A nationwide cohort study among adults in Denmark, 2010-2013, linking register data on C. difficile testing, filled prescriptions, and patient characteristics. All incident episodes of community-associated CDI (ie, positive culture, molecular assay, or toxin test in individuals without previous hospitalization in the prior 12 weeks and without a positive test for C. difficile in the prior 8 weeks) were identified in the Danish National Microbiological Database. Self-controlled case-series analyses were used to estimate incidence rate ratios (IRRs) for community-associated CDI, comparing periods with and without exposure to PPIs. By design, models took fixed confounders such as chronic disease, genetics, and socioeconomic status into account; further, time-varying confounders, including hospital stay and antibiotic and corticosteroid use were adjusted for. Results: 3583 episodes of community-associated CDI were identified, of which 964 occurred during current use of PPIs, 324 occurred 0-6 months after treatment cessation, 123 occurred 6-12 months after treatment cessation, and 2172 occurred during time periods without use of PPIs. The adjusted IRR was 2.03 (95% confidence interval, 1.74-2.36), comparing use of PPI with nonuse. The increased risk remained elevated in later time periods: 1.54 (1.31-1.80) for 0-6 months, 1.24 (1.00-1.53) for 6-12 months after current use. Conclusions: Use of PPIs was associated with moderately increased risk of community-associated CDI. The risk remained elevated up to 1 year after PPI treatment had ended.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
Keyword
- C. difficile infection
- epidemiology
- proton-pump inhibitor
- self-controlled case-series analysis
Publication and Content Type
- art (subject category)
- ref (subject category)
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