The combined use of proton pump inhibitors and antibiotics as risk factors for Clostridium difficile infection

Purpose A review of the incidence of Clostridium. difficile infection (CDI) at our hospital was performed due to the morbidity of CDI in its fulminate form, reports of the increased incidence of CDI in the United States and the increased use of medications associated with its onset. Methods The study was retrospective and took place over a 9-month period, from 1 January 2009 through 30 September 2009. Results There were 88 cases of CDI in the course of the review which amounted to 5.1 infections per 1000 patient hospital admissions. The percentage of overall admissions that were prescribed antibiotics and proton pump inhibitors (PPI), PPI alone or antibiotics alone were 17.1%, 15.5% and 24.3%, respectively. Of all cases of CDI, 59.1% of patients were on both a PPI and antibiotic, 9.1% were on a PPI alone and 13.6% were on an antibiotic alone. Patients on both proton pump inhibitors and antibiotics had an odds ratio of 8.30 (P<0.0001) compared with patients on neither of these medications.