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A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
Published on: May 25, 2017
Comparative Safety of Potassium-Competitive Acid Blockers on the Risk of Clostridioides difficile Infection: A
Gyeongmin Lim1, Ju-Young Shin1,2,3, Da Eun Hyeon4
1Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, Republic of Korea.
Potassium-competitive acid blockers (P-CABs) showed no increased risk of Clostridium difficile infection (CDI) compared to proton pump inhibitors (PPIs) or histamine H2-receptor antagonists (H2RAs). This real-world evidence suggests P-CABs are a safe alternative for acid suppression regarding CDI risk.
Area of Science:
- Gastroenterology
- Pharmacology
- Infectious Disease Epidemiology
Background:
- Proton pump inhibitors (PPIs) are linked to increased Clostridium difficile infection (CDI) risk.
- Limited real-world data exists on the CDI risk associated with potassium-competitive acid blockers (P-CABs).
Purpose of the Study:
- To compare the risk of CDI in patients using P-CABs versus PPIs and histamine H2-receptor antagonists (H2RAs).
Main Methods:
- Retrospective cohort study utilizing standardized electronic health record data from 15 hospitals.
- Propensity score matching (1:4) and Cox proportional hazards models were used for pairwise comparisons.
- Meta-analysis pooled hazard ratios (HRs) and 95% confidence intervals (CIs) across databases.
Main Results:
- P-CAB use was not associated with a higher risk of CDI compared to PPIs (HR: 0.87; 95% CI: 0.69-1.10).
- P-CAB use also showed no increased CDI risk compared to H2RAs (HR: 0.85; 95% CI: 0.64-1.12).
- PPI use was associated with a slightly increased risk of CDI compared to H2RAs (HR: 1.13; 95% CI: 0.98-1.29).
Conclusions:
- Potassium-competitive acid blockers (P-CABs) do not appear to increase the risk of Clostridium difficile infection (CDI).
- Findings suggest P-CABs are a safe alternative to PPIs and H2RAs concerning CDI risk.
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