Risk of community-aquired C. difficile linked to PPIs.(Clinical Rounds)

The use of gastric acid--suppressive drugs was linked to increased risk of community-acquired Clostridium difficile--associated disease in a population-based case-control study, reported Dr. Sandra Dial of McGill University, Montreal, and her associates.

Prior hospitalization, recent exposure to antibiotics, and age also significantly increased the risk of C. difficile--associated disease (CDAD), they found.

An association between proton pump inhibitor use and hospital-acquired CDAD has been shown in several case-control studies. The researchers sought to determine whether the same relationship applied to community-acquired CDAD.

Using data from the United Kingdom General Practice Research Database (GPRD), which holds medical records on about 3 million U.K. patients in more that 400 medical practices, Dr. Dial and her associates compared records of all the patients in the GPRD with a first occurrence of CDAD during 1994-2004 (1,672) with those of 10 age-matched controls from the same medical practice.

They then compared the subset of CDAD patients who had not been hospitalized in the year before the index date (1,233) with 10 controls from the same practices. These patients were considered to have community-acquired CDAD (JAMA ...