Related Experiment Video
Updated: Jan 9, 2026
Retinal and Choroidal Thickness Changes in Populations with Helicobacter pylori Infection by Swept-Source Optical Coherence Tomography
Published on: November 1, 2024
Risk of Clostridioides difficile Infection After Helicobacter pylori Treatment in a Large Population in the United
Lawrence J Leung1, Sophie A Merchant2, Jessica M Badalov2
1Department of Gastroenterology, Kaiser Permanente Northern California, San Francisco, California.
Background And Aims:
Adverse outcomes associated with the treatment of Helicobacter pylori remain poorly understood. We investigated whether H pylori treatment was associated with an increased risk of Clostridioides difficile infection (CDI).
Methods:
This retrospective cohort study included all adult members who tested positive for H pylori between January 1, 2000, and December 31, 2020, at Kaiser Permanente Northern California. We measured the incidence of CDI after H pylori treatment and evaluated the predictors of CDI using multivariable logistic regression.
Results:
Of 139,226 individuals who tested positive for H pylori, the incidence of CDI was 5.9/10,000 within 3 months (P = .02) and 7.0/10,000 (P = .003) within 6 months after H pylori treatment, compared with 2.7/10,000 among untreated individuals. The adjusted odds ratio (aOR) (95% confidence interval) for CDI within 3 months after H pylori treatment was 2.00 (1.02-3.90) overall, 3.15 (1.14-8.70) for concomitant therapy, and 6.34 (2.75-14.59) for bismuth quadruple therapy. Inflammatory bowel disease (IBD) (aOR, 7.89 [2.38-26.21]) and history of CDI (aOR, 8.27 [1.92-35.62]) had the strongest association with CDI, while Asians/Pacific Islanders (aOR, 0.22 [0.09-0.55] and non-English language preference (aOR, 0.30 [0.12-0.72]) were associated with a lower risk.
Conclusion:
In a large, diverse, community-based population, treatment of H pylori was associated with an increased risk of CDI, although the overall incidence was very low. History of IBD and prior CDI were the strongest predictors of CDI. These findings support the safety of H pylori treatment, although caution should be exercised when treating H pylori among individuals with IBD or a prior history of CDI.
Related Concept Videos
01:16Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy
01:26Peptic Ulcer Disease IV: Management
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
01:30Peptic Ulcer Disease I: Introduction
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
01:17Transmission-based Precautions I: Contact, Enteric, and Droplets
Contact Precautions:
Contact precautions are the measures taken to prevent the transmission of infectious agents, especially epidemiologically important microorganisms such as MRSA or influenza, primarily transmitted through direct or indirect contact with an...
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...