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Systematic review with meta-analysis
Proton pump inhibitor use may be associated with an increased risk of Clostridium difficile infection
  1. Vanessa Stevens1,
  2. Edwin van Wijngaarden2
  1. 1Department of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, University of Utah College of Pharmacy, Salt Lake City, Utah, USA
  2. 2Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
  1. Correspondence to : Dr Vanessa Stevens
    Pharmacotherapy Outcomes Research Center, University of Utah College of Pharmacy, 421 Wakara Way, Suite 208, Salt Lake City, UT 84103, USA; vanessa.stevens{at}pharm.utah.edu

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Commentary on: Kwok CS, Arthur AK, Anibueze CI, et al. Risk of Clostridium difficile infection with acid suppressing drugs and antibiotics: meta-analysis. Am J Gastroenterol 2012;107:1011–19.

Context

Proton pump inhibitors (PPI) are a safe and effective treatment of acid-related disorders such as gastroesophageal reflux disease and Barrett's oesophagus. However, they may be associated with an increased risk of Clostridium difficile infection (CDI).

Methods

Kwok and colleagues conducted a systematic review and meta-analysis of observational studies evaluating the association between PPI and the risk of primary or recurrent CDI. Relevant articles were identified through a comprehensive literature search including MEDLINE, EMBASE (from database inception to December 2011) and reference lists of articles retrieved from these bibliographical databases. Studies were eligible for inclusion in the meta-analysis if they were either case–control or cohort design, and either reported OR, risk ratios (RR) or provided sufficient data to allow manual calculation of these effect measures. Data were abstracted by one of …

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