Proton pump inhibitors as a risk factor for recurrence of Clostridium-difficile-associated diarrhea

doi:10.3748/wjg.v16.i28.3573

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Jul 28, 2010 (publication date) through Feb 27, 2025

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Jul 28, 2010; 16(28): 3573-3577
Published online Jul 28, 2010. doi: 10.3748/wjg.v16.i28.3573

Table 1 Univariate analysis of risk factors for recurrence of Clostridium-difficile-associated diarrhea (mean ± SD) n (%)

	Recurrence group (n = 27)	Non-recurrence group (n = 98)	P value
Age (≥ 65 yr)	16 (59.3)	31 (31.6)	0.021^a
Female	15 (55.6)	53 (54.1)	0.905
Length of hospital stay (d)	36.5 ± 9.7	32.8 ± 8.5	0.152
Duration of antibiotics used (d)	13.1 ± 6.8	12.2 ± 5.8	0.105
Admission from institution	6 (22.2)	17 (17.4)	0.379
Severe CDAD	13 (48.2)	30 (30.6)	0.156
Comorbidities
Diabetes mellitus	11 (40.7)	37 (37.8)	0.572
Malignancy	10 (37.1)	31 (31.6)	0.560
Renal failure	5 (18.5)	12 (12.3)	0.215
Active tuberculosis	2 (7.4)	6 (6.1)	0.719
NGT feeding	13 (48.1)	23 (23.5)	0.045^a
WBC count, (mean) × 10³/mm³	15.1 ± 9.7	12.3 ± 8.1	0.413
WBC count > 15 × 10³/mm³	(44.4)	(40.8)
Hb (g/dL)	10.9 ± 1.9	11.4 ± 1.6	0.279
Serum albumin (g/dL)	2.3 ± 0.5	3.1 ± 0.4	0.025^a
Serum albumin < 2.5 g/dL	(59.3)	(36.7)
Creatinine (mg/dL)	1.5 ± 1.4	1.2 ± 1.6	0.513
C-reactive protein (g/dL)	7.3 ± 4.8	5.6 ± 4.5	0.579
Use of PPIs	17 (63.0)	39 (39.8)	0.014^a

^aP < 0.05. CDAD: Clostridium-difficile-associated diarrhea; WBC: White blood cells; NGT: Nasogastric tube.

Table 2 Multivariate analysis of risk factors for recurrence of Clostridium-difficile-associated diarrhea

Risk factor	Adjusted OR	95% CI	P value
Age (≥ 65 yr)	1.32	1.12-3.87	0.031^a
Low serum albumin of < 2.5 g/dL	1.85	1.35-4.91	0.028^a
Concurrent use of PPI	3.48	1.64-7.69	0.016^a
NGT feeding	1.25	0.91-2.65	0.068

^aP < 0.05. NGT: Nasogastric tube; PPI: Proton pump inhibitor.

Table 3 Comparison of antibiotics used before diagnosis of Clostridium-difficile-associated diarrhea between non-recurrent and recurrent group (mean ± SD) n (%)

Type of antibiotics used	Non-recurrent CDAD (n = 98)	Recurrent CDAD (n = 27)	P value
No. of antibiotics used	2.58 ± 0.9	2.43 ± 0.8	0.560
No antibiotics	4 (4.1)	1 (3.7)	0.638
1 antibiotics	28 (28.6)	9 (33.3)	0.497
≥ 2 antibiotics	64 (65.3)	19 (70.4)	0.435
Penicillin analogue	19 (19.4)	6 (22.2)	0.561
Cephalosporin	79 (80.6)	22 (81.4)	0.613
Clindamycin	26 (26.5)	6 (22.2)	0.265
Quinolone	17 (17.3)	7 (25.9)	0.217
Macrolide	8 (8.2)	2 (7.4)	0.691
Carbapenem	11 (11.2)	5 (18.5)	0.215
Metronidazole	6 (6.1)	2 (7.4)	0.563
Vancomycin	3 (3.1)	1 (3.7)	0.729

CDAD: Clostridium-difficile-associated diarrhea.

Citation: Kim JW, Lee KL, Jeong JB, Kim BG, Shin S, Kim JS, Jung HC, Song IS. Proton pump inhibitors as a risk factor for recurrence of Clostridium-difficile-associated diarrhea. World J Gastroenterol 2010; 16(28): 3573-3577
URL: https://www.wjgnet.com/1007-9327/full/v16/i28/3573.htm
DOI: https://dx.doi.org/10.3748/wjg.v16.i28.3573