Comparison of the Hospital-Acquired Clostridium difficile Infection Risk of Using Proton Pump Inhibitors versus Histamine-2 Receptor Antagonists for Prophylaxis and Treatment of Stress Ulcers: A Systematic Review and Meta-Analysis
1
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Background/Aims: Although proton pump inhibitors (PPIs) have been widely used for the prevention and treatment of stress gastric ulcers in hospital settings, there are concerns that PPIs increase the risk of Clostridium difficile infection (CDI). However, little is known about the risk of CDI following PPI and histamine-2 receptor antagonist (H2RA) use. We evaluated the comparative hospital-acquired CDI occurrence risk associated with the concurrent use of PPIs versus H2RAs. Methods: A systematic search of PubMed, MEDLINE/Ovid, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and Google Scholar through August 19, 2016, identified 12 studies that reported the hospital-acquired CDI occurrence following H2RA and PPI use for the prevention and treatment of stress gastric ulcers. Random-effects pooled odds ratios and 95% confidence intervals were estimated. Heterogeneity was measured using I2, and a meta-regression analysis was conducted. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used to assess the overall quality of the evidence. Results: A total of 74,132 patients from 12 observational studies were analyzed. Compared to H2RAs, PPIs increased the risk of CDI by 38.6% (pooled odds ratio, 1.386; 95% confidence interval, 1.152 to 1.668; p=0.001; I2=42.81%). Subgroup analyses of the purpose of study medication use, study site, and study design confirmed the consistency of a greater CDI risk with PPIs than with H2RAs. The overall quality of evidence was rated as low. Conclusions: The use of PPIs for both the prevention and treatment of stress ulcers was associated with a 38.6% increased risk of hospital-acquired CDI occurrence compared to H2RA use.
Abstract
Background/Aims: Although proton pump inhibitors (PPIs) have been widely used for the prevention and treatment of stress gastric ulcers in hospital settings, there are concerns that PPIs increase the risk of Clostridium difficile infection (CDI). However, little is known about the risk of CDI following PPI and histamine-2 receptor antagonist (H2RA) use. We evaluated the comparative hospital-acquired CDI occurrence risk associated with the concurrent use of PPIs versus H2RAs. Methods: A systematic search of PubMed, MEDLINE/Ovid, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and Google Scholar through August 19, 2016, identified 12 studies that reported the hospital-acquired CDI occurrence following H2RA and PPI use for the prevention and treatment of stress gastric ulcers. Random-effects pooled odds ratios and 95% confidence intervals were estimated. Heterogeneity was measured using I2, and a meta-regression analysis was conducted. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used to assess the overall quality of the evidence. Results: A total of 74,132 patients from 12 observational studies were analyzed. Compared to H2RAs, PPIs increased the risk of CDI by 38.6% (pooled odds ratio, 1.386; 95% confidence interval, 1.152 to 1.668; p=0.001; I2=42.81%). Subgroup analyses of the purpose of study medication use, study site, and study design confirmed the consistency of a greater CDI risk with PPIs than with H2RAs. The overall quality of evidence was rated as low. Conclusions: The use of PPIs for both the prevention and treatment of stress ulcers was associated with a 38.6% increased risk of hospital-acquired CDI occurrence compared to H2RA use.
참고문헌 (40)
- Bartlett JG, "Role of Clostridium difficile in antibiotic-associated pseudomembranous colitis", Gastroenterology, 75, pp.778~782 (1978)
- Lessa FC, "Burden of Clostridium difficile infection in the United States", N Engl J Med, 372, pp.825~834 (2015)
- McFarland LV, "Nosocomial acquisition of Clostridium difficile infection", N Engl J Med, 320, pp.204~210 (1989)
- Samore MH, "Clinical and molecular epidemiology of sporadic and clustered cases of nosocomial Clostridium difficile diarrhea", Am J Med, 100, pp.32~40 (1996)
- Shah S, "Gastric acid suppression does not promote clostridial diarrhoea in the elderly", QJM, 93, pp.175~181 (2000)
- Muto CA, "A large outbreak of Clostridium difficile-associated disease with an unexpected proportion of deaths and colectomies at a teaching hospital following increased fluoroquinolone use", Infect Control Hosp Epidemiol, 26, pp.273~280 (2005)
- Kazakova SV, "A hospital outbreak of diarrhea due to an emerging epidemic strain of Clostridium difficile", Arch Intern Med, 166, pp.2518~2524 (2006)
- Jayatilaka S, "Clostridium difficile infection in an urban medical center: five-year analysis of infection rates among adult admissions and association with the use of proton pump inhibitors", Ann Clin Lab Sci, 37, pp.241~247 (2007)
- Dubberke ER, "Evaluation of Clostridium difficile-associated disease pressure as a risk factor for C difficile-associated disease", Arch Intern Med, 167, pp.1092~1097 (2007)
- Aseeri M, "Gastric acid suppression by proton pump inhibitors as a risk factor for clostridium difficile-associated diarrhea in hospitalized patients", Am J Gastroenterol, 103, pp.2308~2313 (2008)
- Howell MD, "Iatrogenic gastric acid suppression and the risk of nosocomial Clostridium difficile infection", Arch Intern Med, 170, pp.784~790 (2010)
- Loo VG, "Host and pathogen factors for Clostridium difficile infection and colonization", N Engl J Med, 365, pp.1693~1703 (2011)
- Stevens V, "Differential risk of Clostridium difficile infection with proton pump inhibitor use by level of antibiotic exposure", Pharmacoepidemiol Drug Saf, 20, pp.1035~1042 (2011)
- Barletta JF, "Proton pump inhibitors and the risk for hospital-acquired Clostridium difficile infection", Mayo Clin Proc, 88, pp.1085~1090 (2013)
- Barletta JF, "Proton pump inhibitors increase the risk for hospital-acquired Clostridium difficile infection in critically ill patients", Crit Care, 18, pp.714~ (2014)
- Youngouk Ro, "Risk of Clostridium difficile Infection with the Use of a Proton Pump Inhibitor for Stress Ulcer Prophylaxis in Critically Ill Patients", Gut and Liver, 10(4), pp.581~586 (2016), 거트앤리버 발행위원회
- Thorens J, "Bacterial overgrowth during treatment with omeprazole compared with cimetidine: a prospective randomised double blind study", Gut, 39, pp.54~59 (1996)
- "Drug safety communication: Clostridium difficile-associated diarrhea can be associated with stomach acid drugs known as proton pump inhibitors (PPIs)" (2016)[URL]
- Tleyjeh IM, "Association between proton pump inhibitor therapy and clostridium difficile infection: a contemporary systematic review and meta-analysis", PLoS One, 7, pp.e50836~ (2012)
- Kwok CS, "Risk of Clostridium difficile infection with acid suppressing drugs and antibiotics: meta-analysis", Am J Gastroenterol, 107, pp.1011~1019 (2012)
- Janarthanan S, "Clostridium difficile-associated diarrhea and proton pump inhibitor therapy: a meta-analysis", Am J Gastroenterol, 107, pp.1001~1010 (2012)
- Deshpande A, "Association between proton pump inhibitor therapy and Clostridium difficile infection in a meta-analysis", Clin Gastroenterol Hepatol, 10, pp.225~233 (2012)
- MacLaren R, "Histamine-2 receptor antagonists vs proton pump inhibitors on gastrointestinal tract hemorrhage and infectious complications in the intensive care unit", JAMA Intern Med, 174, pp.564~574 (2014)
- Moher D, "PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement", Ann Intern Med, 151, pp.264~269 (2009)
- Guyatt GH, "GRADE: an emerging consensus on rating quality of evidence and strength of recommendations", BMJ, 336, pp.924~926 (2008)
- Guyatt GH, "GRADE guidelines 6. Rating the quality of evidence: imprecision", J Clin Epidemiol, 64, pp.1283~1293 (2011)
- "GRADEpro" (2015)[URL]
- DerSimonian R, "Meta-analysis in clinical trials", Control Clin Trials, 7, pp.177~188 (1986)
- ASHP therapeutic guidelines on stress ulcer prophylaxis, "ASHP Commission on Therapeutics and approved by the ASHP board of directors on November 14, 1998", Am J Health Syst Pharm, 56, pp.347~379 (1998)
- "Practice management guidelines for stress ulcer prophylaxis: EAST Practice Management Guidelines Committee" (2008)[URL]
- Cook DJ, "The attributable mortality and length of intensive care unit stay of clinically important gastrointestinal bleeding in critically ill patients", Crit Care, 5, pp.368~375 (2001)
- Grube RR, "Stress ulcer prophylaxis in hospitalized patients not in intensive care units", Am J Health Syst Pharm, 64, pp.1396~1400 (2007)
- Choudhry MN, "Overuse and inappropriate prescribing of proton pump inhibitors in patients with Clostridium difficile-associated disease", QJM, 101, pp.445~448 (2008)
- Alhazzani W, "Proton pump inhibitors versus histamine 2 receptor antagonists for stress ulcer prophylaxis in critically ill patients: a systematic review and meta-analysis", Crit Care Med, 41, pp.693~705 (2013)
- Barkun AN, "Cost-effectiveness analysis: stress ulcer bleeding prophylaxis with proton pump inhibitors, H2 receptor antagonists", Value Health, 16, pp.14~22 (2013)
- Harris RA, "Proton pump inhibitors or histamine-2 receptor antagonists for the prevention of recurrences of erosive reflux esophagitis: a cost-effectiveness analysis", Am J Gastroenterol, 92, pp.2179~2187 (1997)
- Dubberke ER, "Burden of Clostridium difficile on the healthcare system", Clin Infect Dis, 55(Suppl 2), pp.S88~S92 (2012)
- Olsen MA, "The burden of Clostridium difficile infection: estimates of the incidence of CDI from U.S. administrative databases", BMC Infect Dis, 16, pp.177~ (2016)
- Al-Tureihi FI, "Albumin, length of stay, and proton pump inhibitors: key factors in Clostridium difficile-associated disease in nursing home patients", J Am Med Dir Assoc, 6, pp.105~108 (2005)
- Dubberke ER, "Identification of medicare recipients at highest risk for Clostridium difficile infection in the US by population attributable risk analysis", PLoS One, 11, pp.e0146822~ (2016)
