Evidence map›Paper›PMID 32386313›Full record

SynthesisClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021

Acid Suppression Medications During Hospitalization as a Risk Factor for Recurrence of Clostridioides difficile Infection: Systematic Review and Meta-analysis.

Palna Mehta, Ronald G Nahass, Luigi Brunetti

Open access · greenAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 2 pooled it
0.4field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.

  1. Pooled it
  2. Guidelines on optimizing the use of proton pump inhibitors: PPI stewardship.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2023
    Guideline
  3. Trial
  4. Predictors of RecurrentDiagnostics (Basel, Switzerland) · 2026
    Article
  5. Article
  6. Article
  7. Article
  8. Review
  9. Clinical microbiology reviews · 2024
    Review
  10. Article
  11. Review
  12. Review
  13. Le infezioni in medicina · 2024
    Review
  14. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Palna MehtaDepartment of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey; Piscataway, New Jersey, USA.
Ronald G NahassDepartment of Infection Prevention, Robert Wood Johnson University Hospital Somerset, Somerville, New Jersey, USA.
Luigi BrunettiDepartment of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey; Piscataway, New Jersey, USA.ORCID 0000-0003-0565-6167
Rutgers, The State University of New Jersey · USSomerset Medical Center · US

Funding

Summer Research Training in Environmental Health SciencesR25ES020721 · NIEHS · RUTGERS, THE STATE UNIV OF N.J. · PI Lauren M Aleksunes, Debra L Laskin · 2011 to 2026
$1.2M
NIEHS NIH HHS R25 ES020721
6 · The paper itself

Abstract

backgroundStudies have had conflicting results regarding the influence of acid-suppression medications (ASMs) during hospitalization on the recurrence of Clostridioides difficile infection (CDI).

methodsA systematic review and meta-analysis investigating the association between recurrent CDI and ASM use in inpatients was performed. Relevant literature was identified using Medline, Google Scholar, and Web of Science. All human studies were considered regardless of publication date. Case-control and cohort studies and clinical trials were included if they contained the necessary information to calculate appropriate statistics related to the objective of this study. Review articles, meta-analyses, and commentaries were excluded; however, their references were searched to identify any studies missed. The random-effects model was selected since significant heterogeneity in study design was identified. To evaluate the sensitivity of the analysis various subgroup analyses were performed.

resultsOur search identified 9 studies involving 5668 patients of whom 1003 (17.7%) developed recurrent CDI. Patients on ASM were 64% more likely to develop recurrent CDI than patients not on ASM (OR, 1.64; 95% CI, 1.13-2.38; P = .009; I2 = 79.54%). Proton pump inhibitor (PPI) use was associated with an 84% increased risk of recurrent CDI versus no ASM (OR, 1.84; 95% CI, 1.18-2.85; P = .007; I2 = 83.4%).

conclusionsASM use during hospitalization was associated with a 64% increase in recurrent CDI. The association was greater with PPI use. Due to significant heterogeneity in the analyses, additional studies are essential to further elucidate iatrogenic effects of ASM. Unnecessary PPI use should be discontinued.

Indexed as

Clostridioides difficileClostridium InfectionsClostridioidesHospitalizationHumansProton Pump InhibitorsRecurrenceRisk FactorsProton Pump Inhibitorsacid suppressionClostridioides difficile infectionhistamine 2 receptor antagonistsmeta-analysisproton pump inhibitors

Identifiers

PMID32386313
PMCPMC8246810
OpenAlexW3020994278

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.