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Proton pump inhibitors as a risk factor for paediatric Clostridium difficile infection

R Turco1, M Martinelli, E Miele

  • 1Department of Pediatrics, University of Naples Federico II, Naples, Italy.

Alimentary Pharmacology & Therapeutics
|January 6, 2010
PubMed

Insights

Children using proton pump inhibitors (PPIs) have a higher risk of developing Clostridium difficile-associated disease (CDAD). This study investigated the link between acid-suppressing medications and CDAD in pediatric patients.

Area of Science:

  • Pediatric Gastroenterology
  • Infectious Diseases
  • Pharmacology

Background:

  • Gastric acid-suppressing agents like proton pump inhibitors (PPIs) and H2 receptor antagonists (H2RAs) are linked to Clostridium difficile-associated disease (CDAD) in adults.
  • The association between these medications and CDAD in children is not well understood.

Purpose of the Study:

  • To examine the relationship between CDAD and acid-suppressive therapy in hospitalized children.
  • To identify risk factors for CDAD in pediatric patients.

Main Methods:

  • Retrospective review of medical records for hospitalized children diagnosed with protracted diarrhea and abdominal pain.
  • Stool analysis for C. difficile toxins was performed.
  • Identified 68 CDAD patients and matched them with controls; recorded comorbidities, hospitalizations, and medication use (antibiotics, corticosteroids, immunosuppressants, acid suppressors).

Main Results:

  • Proton pump inhibitor (PPI) use was significantly higher in children with CDAD compared to controls (OR = 4.5, 95% CI = 1.4-14.4).
  • A trend suggested increased H2 receptor antagonist (H2RA) use in children with CDAD (OR = 3.8, 95% CI = 0.7-18.9).

Conclusions:

  • Pediatric patients exposed to proton pump inhibitors (PPIs) appear to be at an elevated risk for developing Clostridium difficile-associated disease.
  • Further research is warranted to elucidate the mechanisms and confirm the findings.
Abstract

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