Proton pump inhibitor use does not increase C. diff infection risk in the ICU: 5 insights

Exposure to antibiotics, rather than proton pump inhibitor use, was the most important risk factor for developing Clostridium difficile infection in the intensive care unit, according to a study in The American Journal of Gastroenterology.

The investigators analyzed data from all adult ICU patients at three affiliated hospitals between 2010 and 2013. They excluded patients who had recent C. diff infections, and focused on patients with healthcare facility-onset C. diff infections. They also excluded patients who had ICU stays of less than three days. The researchers found that 18,134 patients met the criteria.

Here are five insights:

1. Of the 18,134 patients, 271 patients (or 1.5 percent) developed healthcare facility-onset C. diff infections in the ICU.

2. Receiving antibiotics was the strongest risk factor for developing C. diff infections.  

3. Proton pump inhibitors did not significantly increase the risk for C. diff infections among those patients who did not receive antibiotics.

4. Proton pump inhibitor use correlated with a decreased risk of C. diff infections in those who received antibiotics.

5. There was also no evidence of increased risk for C. diff infections in those patients who received higher doses of proton pump inhibitors.

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