proton pump inhibitors (PPI) and increased Clostridium difficile infection

Last reviewed 01/2018

Increased Clostridium difficile infection if using proton pump inhibitors

• overall, it appears that proton pump inhibitors (PPI) are associated with increased risk of incident and recurrent Clostridium difficile infection (CDI), based on a consistent direction of association observed in the majority of studies included in the meta-analysis
  • the study authors concluded "... Despite the substantial statistical and clinical heterogeneity, our findings indicate a probable association between PPI use and incident and recurrent CDI. This risk is further increased by concomitant use of antibiotics and PPI, whereas H2 receptor antagonists may be less harmful..."

Reference:

• (1) Kwok CS et al. Risk of Clostridium difficile infection with acid suppressing drugs and antibiotics: meta-analysis. Am J Gastroenterol. 2012 Jul;107(7):1011-9.