ArticleCritical care (London, England)2014
Proton pump inhibitors increase the risk for hospital-acquired Clostridium difficile infection in critically ill patients.
Article in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 8 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
46 citing papers in PubMed, 8 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- Association between Proton Pump Inhibitor andDigestive diseases (Basel, Switzerland) · 2026Pooled it
- Stress ulcer prophylaxis with proton pump inhibitors or histamine 2 receptor antagonists in critically ill adults - a meta-analysis of randomized controlled trials with trial sequential analysis.BMC gastroenterology · 2019Pooled it
- Global burden ofJournal of global health · 2019Pooled it
- Sociedade Portuguesa de Cuidados Intensivos guidelines for stress ulcer prophylaxis in the intensive care unit.Revista Brasileira de terapia intensiva · 2019Guideline
- Magnitude and direction of the association between Clostridium difficile infection and proton pump inhibitors in adults and pediatric patients: a systematic review and meta-analysis.Journal of gastroenterology · 2018Pooled it
- Comparison of the Hospital-AcquiredGut and liver · 2017Pooled it
- Proton pump inhibitors therapy and risk of Clostridium difficile infection: Systematic review and meta-analysis.World journal of gastroenterology · 2017Pooled it
- Assessing the Risk of Hospital-Acquired Clostridium Difficile Infection With Proton Pump Inhibitor Use: A Meta-Analysis.Infection control and hospital epidemiology · 2016Pooled it
- The Mortality Risk of Proton Pump Inhibitors in 1.9 Million US Seniors: An Extended Cox Survival Analysis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022Trial
- Letter to the Editor: Proton Pump Inhibitors and Depression: Implications for Perioperative Stress Ulcer Prophylaxis.Journal of Korean medical science · 2026Article
- Identifying and Resolving Drug-Related Problems in Geriatric Patients.Hospital pharmacy · 2026Review
- Guidelines for Antibiotics Prescription in Critically Ill Patients.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Fecal microbiota transplant for treatment of diarrhea in adult hospitalized horses-111 cases (2013-2018).Open veterinary journal · 2023Article
- Proton Pump Inhibitors Use and Increased Risk of Spontaneous Bacterial Peritonitis in Cirrhotic Patients: A Retrospective Cohort Analysis.Gastroenterology research · 2022Article
- A Nomogram for Individualized Prediction of Stress-Related Gastrointestinal Bleeding in Critically Ill Patients with Primary Intracerebral Hemorrhage.Neuropsychiatric disease and treatment · 2022Article
- Patient Awareness of Reported Adverse Effects Associated with Proton Pump Inhibitors in a Medically Underserved Community.Healthcare (Basel, Switzerland) · 2020Article
- Healthcare facility-onset, healthcare facility-associatedThe journal of spinal cord medicine · 2020Article
- Risk factors and intestinal microbiota: Clostridioides difficile infection in patients receiving enteral nutrition at Intensive Care Units.Critical care (London, England) · 2020Article
- Adherence to a stress ulcer prophylaxis protocol by critically ill patients: a prospective cohort study.Revista Brasileira de terapia intensiva · 2020Article
- [Additive therapies : Intensive care studies from 2018-2019].Der Anaesthesist · 2020Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionProton pump inhibitors (PPI) have been linked to Clostridium difficile infection (CDI) but there are few data specific to ICU patients. We evaluated duration of PPI exposure as a potential risk factor for hospital-acquired CDI in the ICU.
methodsThis retrospective, case-control study was conducted using the Multiparameter Intelligent Monitoring in Intensive Care II database, a large publically available database of more than 35,000 ICU patients. Adult patients with CDI were identified using the ICD-9 code for Clostridium difficile listed as a secondary diagnosis. To be included, patients had to be present in an ICU for ≥ 48 hours prior to Clostridium difficile acquisition. These patients were then matched to patients without CDI using the ICD-9 primary diagnosis, age (+/-5 years) and SOFA score (+/-1). Successfully matched patients were reviewed for PPI exposure and other potential confounding variables for CDI. PPI exposure was characterized as short (<2 days) or long (≥ 2 days). Multivariate modeling was performed to identify independent risk factors for CDI.
resultsThere were 408 patients evaluated and 81% received a PPI. The percentage of patients who had a long exposure to PPIs was 83% in the CDI group compared to 73% with controls (P = 0.012). Upon inclusion of the following variables into a multivariate analysis (long PPI exposure, histamine-2-receptor antagonist administration, antibiotic administration, immunosuppression and study duration), long PPI exposure (odds ratio (OR) (95% confidence interval (CI) = 2.03 (1.23 to 3.36), P = 0.006) and antibiotic use (OR (95% CI) = 2.52 (1.23 to 5.18), P = 0.012) were identified as independent predictors of CDI.
conclusionsProton pump inhibitors are independent risk factors for the development of CDI in ICU patients. This risk is particularly exposed after two or more days of therapy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.