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Acid-Suppressing Agents and Risk for Clostridium difficile Infection in Pediatric Patients

Katelyn E Brown1, Chad A Knoderer2, Kristen R Nichols2

  • 1Purdue University, West Lafayette, IN, USA kejensen@purdue.edu.

Clinical Pediatrics
|February 4, 2015
PubMed

Insights

Children using home acid-suppressive therapy with histamine-2 receptor antagonists (H2RAs) face a nearly 4.5 times higher risk of Clostridium difficile infection (CDI). Further research into H2RA use in pediatric patients is warranted.

Area of Science:

  • Pediatric Infectious Diseases
  • Gastroenterology
  • Pharmacology

Background:

  • Acid-suppressing agents are linked to increased Clostridium difficile infection (CDI) risk in adults.
  • The association between acid-suppressing therapy and CDI in children remains less understood.

Purpose of the Study:

  • To evaluate the association between acid-suppressing therapy and the development of CDI in a pediatric population.
  • To identify specific acid-suppressing agents that may increase CDI risk in children.

Main Methods:

  • A retrospective case-control study design was employed.
  • Children aged 1-17 years with positive C. difficile PCR results were matched with controls having negative PCR results.
  • Data on acid-suppressive therapy use prior to PCR testing were collected and analyzed.

Main Results:

  • No significant difference in overall acid-suppressive therapy use was found between CDI-positive and CDI-negative pediatric patients.
  • However, histamine-2 receptor antagonist (H2RA) use was significantly higher in CDI-positive children (32.8%) compared to CDI-negative children (14.9%).
  • Home H2RA therapy was identified as an independent predictor of CDI in children (odds ratio = 4.6).

Conclusions:

  • Pediatric patients receiving home H2RA therapy exhibit a substantially increased risk of developing CDI.
  • These findings highlight the need for careful consideration and monitoring of H2RA use in children.
  • Further investigation into the mechanisms and implications of H2RA-associated CDI in pediatric populations is recommended.
Abstract

Keywords:
Clostridium difficileH2RAPPIdiarrheapediatric

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