Document Detail


Gastric acid suppression and outcomes in Clostridium difficile infection: a population-based study.
MedLine Citation:
PMID:  22766083     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the association of gastric acid suppression medications, including proton pump inhibitors and histamine type 2 blockers, with outcomes in patients with Clostridium difficile infection (CDI) in a population-based cohort.
PATIENTS AND METHODS: To understand the association between acid suppression and outcomes in patients with CDI, we conducted a population-based study in Olmsted County, Minnesota, from January 1, 1991, through December 31, 2005. We compared demographic data and outcomes, including severe, severe-complicated, and recurrent CDI and treatment failure, in a cohort of patients with CDI who were treated with acid suppression medications with these outcomes in a cohort with CDI that was not exposed to acid-suppressing agents.
RESULTS: Of 385 patients with CDI, 36.4% were undergoing acid suppression (23.4% with proton pump inhibitors, 13.5% with histamine type 2 blockers, and 0.5% with both). On univariate analysis, patients taking acid suppression medications were significantly older (69 vs 56 years; P<.001) and more likely to have severe (34.2% vs 23.6%; P=.03) or severe-complicated (4.4% vs 2.6% CDI; P=.006) infection than patients not undergoing acid suppression. On multivariable analyses, after adjustment for age and comorbid conditions, acid suppression medication use was not associated with severe or severe-complicated CDI. In addition, no association between acid suppression and treatment failure or CDI recurrence was found.
CONCLUSION: In this population-based study, after adjustment for age and comorbid conditions, patients with CDI who underwent acid suppression were not more likely to experience severe or severe-complicated CDI, treatment failure, or recurrent infection.
Authors:
Sahil Khanna; Scott L Aronson; Patricia P Kammer; Larry M Baddour; Darrell S Pardi
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Mayo Clinic proceedings     Volume:  87     ISSN:  1942-5546     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-06     Completed Date:  2012-09-14     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  England    
Other Details:
Languages:  eng     Pagination:  636-42     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Clostridium difficile* / isolation & purification
Comorbidity
Enterocolitis, Pseudomembranous / drug therapy,  epidemiology*
Female
Gastric Acid / metabolism*
Histamine H2 Antagonists / administration & dosage,  adverse effects*
Humans
Infant
Infant, Newborn
Male
Middle Aged
Minnesota / epidemiology
Proton Pump Inhibitors / administration & dosage,  adverse effects*
Recurrence
Retrospective Studies
Severity of Illness Index
Treatment Failure
Young Adult
Grant Support
ID/Acronym/Agency:
R01 AG034676/AG/NIA NIH HHS; R01-AG034676/AG/NIA NIH HHS
Chemical
Reg. No./Substance:
0/Histamine H2 Antagonists; 0/Proton Pump Inhibitors
Comments/Corrections

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