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Meta-Analysis
, 53 (1), 84-94

Magnitude and Direction of the Association Between Clostridium Difficile Infection and Proton Pump Inhibitors in Adults and Pediatric Patients: A Systematic Review and Meta-Analysis

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Meta-Analysis

Magnitude and Direction of the Association Between Clostridium Difficile Infection and Proton Pump Inhibitors in Adults and Pediatric Patients: A Systematic Review and Meta-Analysis

Tadayuki Oshima et al. J Gastroenterol.

Erratum in

Abstract

Background: Clostridium difficile infection (CDI) is a cause of increased morbidity and health care costs among hospitalized patients. Proton pump inhibitors (PPIs) are mainly used for the treatment of acid-related upper gastrointestinal diseases. The aim of the study was to assess the risks associated with initial and recurrent CDI in adult and pediatric patients treated with PPIs.

Methods: A systematic search was performed using PubMed (Medline), Embase, and Web of Science with the following search terms: ("proton pump inhibitor," "PPI," or "acid suppression") AND ("infection," "diarrhea," "diarrhoea," "colitis," or "disease") AND ("Clostridium difficile"). Meta-analysis was performed using Revman5.3 software. Pooled odds ratios (ORs) presented as standard plots with 95% confidence intervals (CIs) were determined.

Results: Sixty-seven eligible studies were selected. PPI use was significantly associated with risk of CDI (OR 2.34, 95% CI 1.94-2.82; P < 0.00001). Pooled data from twelve studies demonstrated a significant association between PPI use and recurrent CDI (OR 1.73, 95% CI 1.39-2.15; P = 0.02). Subgroup analysis revealed significant associations between PPI use and an increased incidence of CDI among adult (OR 2.30, 95% CI 1.89-2.80; P < 0.00001) and pediatric (OR 3.00, 95% CI 1.44-6.23; P < 0.00001) patients.

Conclusions: PPI use was associated with CDI in adult and pediatric patients, and with recurrent CDI. Although many risk factors are associated with the occurrence and recurrence of CDI, consideration should be given to not administering PPIs at any age if they are unnecessary.

Keywords: Clostridium difficile; Meta-analyses.

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References

    1. Infect Control Hosp Epidemiol. 2015 Apr;36(4):452-60 - PubMed

References

    1. Am J Gastroenterol. 2013 Nov;108(11):1794-801 - PubMed

References

    1. Eur J Clin Microbiol Infect Dis. 2012 Oct;31(10):2601-10 - PubMed

References

    1. J Gastroenterol. 2016 Jan;51(1):1-10 - PubMed

References

    1. Clin Infect Dis. 2002 Feb 1;34(3):346-53 - PubMed

References

    1. Infect Control Hosp Epidemiol. 2005 Mar;26(3):273-80 - PubMed

References

    1. J Infect Dis. 2010 Dec 15;202(12):1877-84 - PubMed

References

    1. Br Med J. 1978 Mar 18;1(6114):695 - PubMed

References

    1. Microbiol Immunol. 2007;51(12):1209-14 - PubMed

References

    1. J Hosp Infect. 2016 Feb;92(2):173-7 - PubMed

References

    1. Zhonghua Zhong Liu Za Zhi. 2014 Oct;36(10):773-7 - PubMed

References

    1. Prog Transplant. 2016 Sep;26(3):231-7 - PubMed

References

    1. J Med Microbiol. 2013 Oct;62(Pt 10):1517-23 - PubMed

References

    1. J Antimicrob Chemother. 2014 Apr;69(4):1127-31 - PubMed

References

    1. J Natl Med Assoc. 2007 May;99(5):500-4 - PubMed

References

    1. SAGE Open Med. 2016 Dec 14;4:2050312116684295 - PubMed

References

    1. Aliment Pharmacol Ther. 2011 Dec;34(11-12):1269-81 - PubMed

References

    1. Infect Control Hosp Epidemiol. 2016 Dec;37(12):1408-1417 - PubMed

References

    1. Infect Control Hosp Epidemiol. 1990 Jun;11(6):283-90 - PubMed

References

    1. Am J Med. 2011 Mar;124(3):276.e1-7 - PubMed

References

    1. Am J Gastroenterol. 2010 Jan;105(1):106-13 - PubMed

References

    1. J Hosp Infect. 2003 Jul;54(3):243-5 - PubMed

References

    1. J Infect Dis. 1981 Jan;143(1):42-50 - PubMed

References

    1. Arch Intern Med. 2010 May 10;170(9):772-8 - PubMed

References

    1. CMAJ. 2006 Sep 26;175(7):757 - PubMed

References

    1. Gut. 1996 Jul;39(1):54-9 - PubMed

References

    1. J Clin Microbiol. 2013 May;51(5):1465-73 - PubMed

References

    1. Surgery. 2014 Oct;156(4):972-8 - PubMed

References

    1. Am J Gastroenterol. 2008 Sep;103(9):2308-13 - PubMed

References

    1. Intern Med J. 2012 May;42(5):591-4 - PubMed

References

    1. Gut Liver. 2016 Jul 15;10(4):581-6 - PubMed

References

    1. Arch Intern Med. 2010 May 10;170(9):779-83 - PubMed

References

    1. CMAJ. 2004 Jul 6;171(1):33-8 - PubMed

References

    1. Infect Control Hosp Epidemiol. 2005 Aug;26(8):685-90 - PubMed

References

    1. Pharmazie. 2013 Aug;68(8):706-10 - PubMed

References

    1. Nat Rev Microbiol. 2011 Apr;9(4):233-43 - PubMed

References

    1. Am J Health Syst Pharm. 2007 Nov 15;64(22):2359-63 - PubMed

References

    1. Am J Gastroenterol. 2016 Nov;111(11):1641-1648 - PubMed

References

    1. Clin Infect Dis. 2007 Nov 1;45(9):1141-51 - PubMed

References

    1. N Engl J Med. 2005 Dec 8;353(23):2442-9 - PubMed

References

    1. Crit Care. 2014 Dec 24;18(6):714 - PubMed

References

    1. JAMA Intern Med. 2017 Jun 1;177(6):784-791 - PubMed

References

    1. JAMA. 2005 Dec 21;294(23):2989-95 - PubMed

References

    1. J Am Med Dir Assoc. 2005 Mar-Apr;6(2):105-8 - PubMed

References

    1. Aliment Pharmacol Ther. 2010 Apr;31(7):754-9 - PubMed

References

    1. J Hosp Infect. 2008 Dec;70(4):298-304 - PubMed

References

    1. PLoS One. 2014 Jun 04;9(6):e98400 - PubMed

References

    1. Aliment Pharmacol Ther. 2009 Mar 15;29(6):626-34 - PubMed

References

    1. Clin Infect Dis. 2015 Sep 15;61(6):912-7 - PubMed

References

    1. J Pediatr Gastroenterol Nutr. 2015 Aug;61(2):208-11 - PubMed

References

    1. J Gastrointestin Liver Dis. 2013 Dec;22(4):397-403 - PubMed

References

    1. Clin Exp Gastroenterol. 2015 Jul 14;8:191-6 - PubMed

References

    1. Aliment Pharmacol Ther. 2006 Aug 15;24(4):613-9 - PubMed

References

    1. N Engl J Med. 2011 Nov 3;365(18):1693-703 - PubMed

References

    1. BMJ. 1997 Sep 13;315(7109):629-34 - PubMed

References

    1. Clin Microbiol Infect. 2009 May;15(5):427-34 - PubMed

References

    1. J Hosp Infect. 2013 Feb;83(2):146-9 - PubMed

References

    1. J Clin Gastroenterol. 2012 May-Jun;46(5):397-400 - PubMed

References

    1. World J Gastroenterol. 2010 Jul 28;16(28):3573-7 - PubMed

References

    1. Am J Gastroenterol. 2012 Jul;107(7):1011-9 - PubMed

References

    1. Eur J Clin Microbiol Infect Dis. 2014 Oct;33(10):1741-7 - PubMed

References

    1. Ann Clin Lab Sci. 2007 Summer;37(3):241-7 - PubMed

References

    1. PLoS One. 2014 Jul 08;9(7):e101615 - PubMed

References

    1. PLoS One. 2014 Oct 24;9(10):e110790 - PubMed

References

    1. Infect Control Hosp Epidemiol. 2013 Apr;34(4):407-14 - PubMed

References

    1. Proc Natl Acad Sci U S A. 2011 Mar 15;108 Suppl 1:4578-85 - PubMed

References

    1. PLoS One. 2014 Nov 05;9(11):e111735 - PubMed

References

    1. Clin Infect Dis. 2007 Dec 15;45(12):1543-9 - PubMed

References

    1. J Bone Joint Surg Br. 2010 Jul;92(7):994-8 - PubMed

References

    1. Can J Hosp Pharm. 2010 Jan;63(1):31-7 - PubMed

References

    1. J Investig Med. 2015 Jun;63(5):747-51 - PubMed

References

    1. J Am Geriatr Soc. 2016 Mar;64(3):667-9 - PubMed

References

    1. Clin Pediatr (Phila). 2015 Oct;54(11):1102-6 - PubMed

References

    1. Pharmacotherapy. 2016 Sep;36(9):986-93 - PubMed

References

    1. Infect Control Hosp Epidemiol. 2008 Jan;29(1):44-50 - PubMed

References

    1. PLoS One. 2012;7(12):e50836 - PubMed

References

    1. Eur J Clin Microbiol Infect Dis. 2011 Apr;30(4):587-93 - PubMed

References

    1. Am J Gastroenterol. 2012 Jul;107(7):1001-10 - PubMed

References

    1. BMJ Open. 2015 Oct 26;5(10):e009316 - PubMed

References

    1. J Infect Dis. 1985 Feb;151(2):355-61 - PubMed

References

    1. Arch Intern Med. 2010 May 10;170(9):784-90 - PubMed

References

    1. Hepatogastroenterology. 2013 Sep;60(126):1351-4 - PubMed

References

    1. Rev Esp Enferm Dig. 2016 Jun;108(6):304-8 - PubMed

References

    1. Arch Intern Med. 2006 Dec 11-25;166(22):2518-24 - PubMed

References

    1. Ann Intern Med. 2001 Dec 4;135(11):982-9 - PubMed

References

    1. J Hosp Med. 2014 Feb;9(2):94-8 - PubMed

References

    1. Clin Infect Dis. 2006 Nov 15;43(10):1272-6 - PubMed

References

    1. Dig Dis Sci. 2010 Sep;55(9):2431-40 - PubMed

References

    1. Transplant Proc. 2016 Oct;48(8):2763-2768 - PubMed

References

    1. Mayo Clin Proc. 2013 Oct;88(10):1085-90 - PubMed

References

    1. Pharmacoepidemiol Drug Saf. 2011 Oct;20(10):1035-42 - PubMed

References

    1. Antimicrob Agents Chemother. 2007 Aug;51(8):2883-7 - PubMed

References

    1. CMAJ. 2006 Sep 26;175(7):745-8 - PubMed

References

    1. JAMA Intern Med. 2015 May;175(5):784-91 - PubMed

References

    1. QJM. 2000 Mar;93(3):175-81 - PubMed

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