Discontinuation of unnecessary gastric acid inhibitors can reduce recurrent Clostridium difficile infection

According to research published in JAMA internal medicine, discontinuing the use of unnecessary gastric acid inhibitors can reduce recurrent Clostridium difficile infection and reduce medical costs (http://www.chemdrug.com/invest/253/) "Inhibition of gastric acid has been associated with an increased risk of primary C.difficile infection (CDI), but the risk of recurrent CDI in patients with gastric acid inhibitors (http://www.chemdrug.com/) is unclear," said raseen Tariq, M.D., Gastroenterology and Hepatology division, Mayo Clinic, Minnesota, and colleagues Tariq and colleagues conducted a systematic review and meta-analysis (http://www.chemdrug.com/sell/76/) to determine the association between recurrent CDI and gastric acid inhibitors, including proton pump inhibitors and histamine H2 receptor blockers They searched a number of databases from January 1, 1995 to September 30, 2015, and identified 16 observational studies to assess the link, involving 7703 CDI patients hospitalized and outpatients A total of 19.8% patients (n = 1525) had recurrent CDI The results of me ta-analysis showed that compared with those patients who did not receive gastric acid inhibitor (http://www.chemdrug.com/), patients who received gastric acid inhibitor had an increased risk of recurrent CDI (22.1% vs 17.3%; or = 1.52; 95% CI: 1.2-1.94; P < 0.001) This increased risk was confirmed by subgroup analysis of age adjusted and potential confounding factors (or = 1.38; 95% CI, 1.08-1.76; P = 0.02) Significant heterogeneity was observed in the study, with an I ² value of 64%, the researchers noted "In our study, we found a significant association between the use of gastric acid inhibitors and the risk of recurrent CDI in patients with a history of CDI," said sahil Khanna, another researcher from the Mayo Clinic Although the risk of CDI recurrence may increase in patients with gastric acid suppression, he stressed that these data should be interpreted with caution given factors not considered in the analysis, including why gastric acid inhibitors are needed