Does PPI therapy predispose to Clostridium difficile infection?

• Published in: Nature reviews. Gastroenterology & hepatology Vol. 6; no. 9; pp. 555 - 557
• Main Authors: Minocha, Anil, Pant, Chaitanya, Madonia, Phillip
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.09.2009; Nature Publishing Group
• Subjects: Anti-Bacterial Agents - adverse effects; Biomedicine; Causes of; Clostridium difficile; Clostridium infections; Diagnosis; Dosage and administration; Drug therapy; Economic aspects; Enterocolitis, Pseudomembranous - epidemiology; Enterocolitis, Pseudomembranous - etiology; Esophagitis - drug therapy; Esophagitis - metabolism; Gastric Acid - metabolism; Gastroenterology; Health aspects; Hepatology; Humans; Medicine; Medicine & Public Health; opinion-2; Peptic Ulcer - drug therapy; Peptic Ulcer - metabolism; Proton pump inhibitors; Proton Pump Inhibitors - adverse effects; Proton Pump Inhibitors - pharmacology; Proton Pump Inhibitors - therapeutic use; Risk Factors; United States
• ISSN: 1759-5045; 1759-5053
• DOI: 10.1038/nrgastro.2009.128

The incidence of Clostridium difficile infection has dramatically risen, in concert with the increasing use of PPIs for gastric acid suppression. This Perspective focuses on the role that PPI use may have in C. difficile infection, and weighs up the pros and cons of PPI therapy. Clostridium difficile infection (CDI) has emerged as a problem of epidemic proportions. Previous exposure to broad-spectrum antibiotics remains the most important predisposing factor for the disease. However, PPIs are increasingly being overprescribed and recent research has, therefore, focused on the association between PPI therapy and CDI. While the data remain observational, increasing evidence exists for at least a modest association between PPI use and CDI.