Proton-Pump Inhibitors Increase Risks for C. difficile Infection — Physician’s First Watch
Proton-Pump Inhibitors Increase Risks for C. difficile Infection
Proton-pump inhibitors (PPIs) are overprescribed, and as currently used, their harms mostly outweigh their benefits, researchers and an editorialist argue in the Archives of Internal Medicine.
In one study, researchers analyzed data on more than 100,000 patients from a tertiary-care center to examine the association between intensity of acid-suppression therapy and incidence of nosocomial Clostridium difficile infection. They found that as suppression intensity increased, so did the odds ratio of infection: from 1.0 (no suppression), to 1.53 (with histamine-2–receptor antagonists), to 1.74 (with daily PPIs), to 2.36 (with more frequent PPIs).
Another study showed the effects of introducing guidelines on PPI use for preventing nosocomial upper GI bleeding. After implementation, in-hospital as well as at-discharge prescriptions for PPIs dropped significantly.
An editorialist contends that one half to two thirds of PPIs are prescribed inappropriately and that "for most patients the adverse effects of PPIs outweigh the benefits."