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KMID : 1188320160100040581
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Gut and Liver
2016 Volume.10 No. 4 p.581 ~ p.586
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Risk of Clostridium difficile Infection with the Use of a Proton Pump Inhibitor for Stress Ulcer Prophylaxis in Critically Ill Patients
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Ro Young-Ouk
Eun Chang-Soo
Kim Hyun-Soo
Kim Ji-Yeoun
Byun Young-Jae
Han Dong-Soo
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Abstract
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Background/Aims:Proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs) are commonly prescribed for stress ulcer prophylaxis (SUP) in critically ill patients. Several studies have suggested that the use of PPIs is a potential risk factor for Clostridium difficile infection (CDI). We compared the incidences of CDI in the PPI group and H2RA group for SUP in critically ill patients.
Methods:From August 2005 to July 2012, the incidences of CDI were retrospectively analyzed in patients who were admitted directly to intensive care units and stayed for more than 3 days. SUP-related CDI was defined as a CDI diagnosed during the SUP period. Patient clinical data were analyzed to identify potential risk factors for SUP-related CDI.
Results:Of the 1,005 patients enrolled (444 patients received PPI and 561 received H2RA), 38 (3.8%) were diagnosed with SUP-related CDI. The incidence of SUP-related CDI was considerably higher in patients who received PPI than in those who received H2RA (6.7% vs 1.8%). PPI use for SUP (odds ratio [OR], 3.3; confidence interval [CI], 1.5 to 7.1; p=0.003) and diabetes mellitus (OR, 2.3; CI, 1.2 to 4.7; p=0.019) were independent risk factors for SUP-related CDI.
Conclusions:PPI therapy is associated with a higher risk of SUP-related CDI than H2RA therapy in critically ill patients.
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KEYWORD
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Clostridium difficile, Proton pump inhibitor, Histamine-2 receptor antagonist, Critical care
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