1887
Volume 2017, Issue 2
  • ISSN: 0253-8253
  • E-ISSN: 2227-0426

Abstract

While few international studies have assessed the association between omeprazole use and the risk of infection (CDI), research into this is lacking in Saudi Arabia and the Middle East region. The aim of this study was to determine whether exposure to omeprazole is associated with the risk of infection in a sample of hospitalized Saudi patients. A retrospective matched case–control study was conducted at the King Abdulaziz Medical City in Riyadh, Saudi Arabia, from 1 August 2010 through 31 July 2015. The analysis included a total of 200 patients: 100 CDI cases and 100 matched controls. The majority (60%, 120 out of 200) of patients had received proton pump inhibitors (PPIs), and a minority (18.5%, 37 out of 200) had received omeprazole. The PPI use was insignificantly higher in CDI cases than in controls. However, the use of omeprazole was significantly higher in CDI cases compared with controls. Specifically, patients receiving omeprazole were two times more likely to develop CDI compared with controls (aOR = 2.1, 95% confidence interval (CI) = (1.007–4.437)). After adjusting for potential predictors of CDI, watery diarrhea (aOR = 59.1, 95% CI = 19.831–175.974) and abdominal pain (aOR = 7.5, 95% CI = 2.184–25.445) were found to be independent predictors of CDI. The data suggests that PPIs were commonly used in patients admitted to King Abdulaziz Medical City in Riyadh: six out of ten patients received PPIs. The findings support a possible association between the use of omeprazole and a high risk of CDI. To confirm causality, the link between omeprazole and CDI should be assessed in a large interventional study.

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2017-07-24
2019-08-24
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References

  1. [1]. Rupnik   M., , Wilcox   MH., , Gerding   DN. . Clostridium difficile infection: New developments in epidemiology and pathogenesis. . Nat Rev Microbiol.   2009; ;7: 7 : 526– 536 .
    [Google Scholar]
  2. [2]. Bauer   MP., , Notermans   DW., , Van Benthem   BH., , Brazier   JS., , Wilcox   MH., , Rupnik   M. , et al.   Clostridium difficile infection in Europe: A hospital-based survey. . The Lancet . 2011; ;377: 9759 : 63– 73 .
    [Google Scholar]
  3. [3]. Loo   VG., , Poirier   L., , Miller   MA., , Oughton   M., , Libman   MD., , Michaud   S. , et al.   A predominantly clonal multi-institutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality. . N Engl J Med.   2005; ;353: 23 : 2442– 2449 .
    [Google Scholar]
  4. [4]. McDonald   LC., , Killgore   GE., , Thompson   A., , Owens   Jr RC., , Kazakova   SV., , Sambol   SP. , et al.   An epidemic, toxin gene-variant strain of Clostridium difficile. . N Engl J Med.   2005; ;353: 23 : 2433– 2441 .
    [Google Scholar]
  5. [5]. Wilcox   MH., , Mooney   L., , Bendall   R., , Settle   CD., , Fawley   WN. . A case–control study of community-associated Clostridium difficile infection. . J Antimicrob Chemother . 2008; ;62: 2 : 388– 396 .
    [Google Scholar]
  6. [6]. Lowe   DO., , Mamdani   MM., , Kopp   A., , Low   DE., , Juurlink   DN. . Proton pump inhibitors and hospitalization for Clostridium difficile-associated disease: A population-based study. . Clin Infect Dis.   2006; ;43: 10 : 1272– 1276 .
    [Google Scholar]
  7. [7]. Dial   S., , Alrasadi   K., , Manoukian   C., , Huang   A., , Menzies   D. . Risk of Clostridium difficile diarrhea among hospital inpatients prescribed proton pump inhibitors: Cohort and case–control studies. . Can Med Assoc J.   2004; ;171: 1 : 33– 38 .
    [Google Scholar]
  8. [8]. Aseeri   M., , Schroeder   T., , Kramer   J., , Zackula   R. . Gastric acid suppression by proton pump inhibitors as a risk factor for Clostridium difficile-associated diarrhea in hospitalized patients. . Am J Gastroenterol.   2008; ;103: 9 : 2308– 2313 .
    [Google Scholar]
  9. [9]. Cunningham   R., , Dale   B., , Undy   B., , Gaunt   N. . Proton pump inhibitors as a risk factor for Clostridium difficile diarrhoea. . J Hosp Infect.   2003; ;54: 3 : 243– 245 .
    [Google Scholar]
  10. [10]. Janarthanan   S., , Ditah   I., , Adler   DG., , Ehrinpreis   MN. . Clostridium difficile-associated diarrhea and proton pump inhibitor therapy: A meta-analysis. . Am J Gastroenter.   2012; ;107: 7 : 1001– 1010 .
    [Google Scholar]
  11. [11]. Abramowitz   J., , Thakkar   P., , Isa   A., , Truong   A., , Park   C., , Rosenfeld   RM. . Adverse event reporting for proton pump inhibitor therapy: An overview of systematic reviews. . Otolaryngol Head Neck Surg.   2016; ;155: 4 : 547– 554 .
    [Google Scholar]
  12. [12]. Roughead   EE., , Chan   EW., , Choi   NK., , Griffiths   J., , Jin   XM., , Lee   J. , et al.   Proton pump inhibitors and risk of Clostridium difficile infection: A multi-country study using sequence symmetry analysis. . Expert Opin Drug Saf.   2016; ;15: 12 : 1589– 1595 .
    [Google Scholar]
  13. [13]. Thipmontree   W., , Kiratisin   P., , Manatsathit   S., , Thamlikitkul   V. . Epidemiology of suspected Clostridium difficile-associated hospital-acquired diarrhea in hospitalized patients at Siriraj Hospital. . J Med Assoc Thai.   2011; ;94: Suppl 1 : S207– S216 .
    [Google Scholar]
  14. [14]. Al-Tureihi   FI., , Hassoun   A., , Wolf-Klein   G., , Isenberg   H. . Albumin, length of stay, and proton pump inhibitors: Key factors in Clostridium difficile-associated disease in nursing home patients. . J Am Med Dir Assoc.   2005; ;6: 2 : 105– 108 .
    [Google Scholar]
  15. [15]. Tleyjeh   IM., , Abdulhak   AA., , Riaz   M., , Alasmari   FA., , Garbati   MA., , AlGhamdi   M. , et al.   Association between proton pump inhibitor therapy and Clostridium difficile infection: A contemporary systematic review and meta-analysis. . PLoS ONE.   2012; ;7: 12 : e50836 .
    [Google Scholar]
  16. [16]. Naggie   S., , Miller   BA., , Zuzak   KB., , Pence   BW., , Mayo   AJ., , Nicholson   BP. , et al.   A case-control study of community-associated Clostridium difficile infection: No role for proton pump inhibitors. . Am J Med.   2011; ;124: 3 : 276– 2e1 .
    [Google Scholar]
  17. [17]. Debast   SB., , Vaessen   N., , Choudry   A., , Wiegers-Ligtvoet   EA., , Van Den Berg   RJ., , Kuijper   EJ. . Successful combat of an outbreak due to Clostridium difficile PCR ribotype 027 and recognition of specific risk factors. . Clin Microbiol Infect.   2009; ;15: 5 : 427– 434 .
    [Google Scholar]
  18. [18]. Tleyjeh   IM., , Abdulhak   AA., , Riaz   M., , Alasmari   FA., , Garbati   MA., , AlGhamdi   M. , et al.   Association between proton pump inhibitor therapy and Clostridium difficile infection: A contemporary systematic review and meta-analysis. . PLoS ONE.   2012; ;7: 12 : e50836 .
    [Google Scholar]
  19. [19]. Nath   SK., , Salama   S., , Persaud   D., , Thornley   JH., , Smith   I., , Foster   G. , et al.   Drug risk factors associated with a sustained outbreak of Clostridium difficile diarrhea in a teaching hospital. . Can J Infect Dis Med Microbiol.   1994; ;5: 6 : 270– 275 .
    [Google Scholar]
  20. [20]. Hegarty   JP., , Sangster   W., , Harris   LR., , Stewart   DB. . Proton pump inhibitors induce changes in colonocyte gene expression that may affect Clostridium difficile infection. . Surgery.   2014; ;156: 4 : 972– 978 .
    [Google Scholar]
  21. [21]. Pupaibool   J., , Khantipong   M., , Suankratay   C. . A study of Clostridium difficile-associated disease at King Chulalongkorn Memorial Hospital, Thailand. . J Med Assoc Thai.   2008; ;91: 1 : 37– 43 .
    [Google Scholar]
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  • Article Type: Research Article
Keyword(s): abdominal pain , Clostridium difficile infection , omeprazole , Saudi Arabia and watery diarrhea
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