Proton pump inhibitors and diarrhoea related to Clostridium difficile infection in hospitalised patients: A case-control study

Abstract

The incidence and disease severity of Clostridium difficile infection are rising. There is increasing evidence of a potential association between proton-pump inhibitors (PPI) and C.difficile infection. We performed a case-control study to examine the relationship between PPI and polymerase chain reaction (PCR)-proven C.difficile infection in 137 hospitalised patients in a tertiary hospital in Western Australia. Only antibiotic exposure within 3months prior to onset of diarrhoea was associated with PCR-proven C.difficile infection (odds ratio 5.97, 95% confidence interval 2.40-14.8, P= 0.001). A restricted analysis on those who had exposure to antibiotics within 3months before the onset of diarrhoea did not change the negative association between PPI exposure and PCR-proven C.difficile infection. Long-term PPI usage and intensity of PPI exposure prior to onset of diarrhoea were not significantly associated with C.difficile infection. © 2012 The Authors. Internal Medicine Journal © 2012 Royal Australasian College of Physicians.