ArticleThe Journal of antimicrobial chemotherapy2024
The combined effect of systemic antibiotics and proton pump inhibitors on Clostridioides difficile infection and recurrence.
Article in The Journal of antimicrobial chemotherapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
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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.
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Who cites it
17 citing papers in PubMed, 16 citations in OpenAlex.
- From gut dysbiosis to eubiosis: understanding microbiome recovery as an ecological process.Gut microbes · 2026Review
- Non-absorbable antibiotics worsen alcohol-associated liver disease in gastric acid-suppressed mice.Gut microbes · 2026Article
- Influence of COVID-19 on Clinical Outcomes ofAntibiotics (Basel, Switzerland) · 2026Article
- Impact of Gastric Acid Suppression on Clostridioides difficile Infection: A Systematic Review.Cureus · 2026Review
- Safety of Short-Term Trimethoprim-Sulfamethoxazole Use for Uncomplicated Cystitis: A Nationwide Retrospective Cohort Study.Pharmacoepidemiology and drug safety · 2026Article
- Impact of enteral feeding strategies on nosocomialFrontiers in nutrition · 2026Article
- A Vanished Association Between Proton Pump Inhibitors and Clostridioides Difficile Infection After Minimizing Bias.Journal of clinical medicine · 2025Article
- Changes in the Epidemiology of Clostridioides difficile Infection.Infectious disease clinics of North America · 2025Review
- Review
- Proton Pump Inhibitor Use and Risk of Clostridioides difficile Infection: An Umbrella Review of 11 Meta-Analyses.Cureus · 2025Review
- Recent advances in therapeutic probiotics: insights from human trials.Clinical microbiology reviews · 2025Review
- Presence of Drug Interaction Between Penicillin and Hormonal Contraceptives in Women: A Scoping Review.Healthcare (Basel, Switzerland) · 2025Review
- Trends in Proton Pump Inhibitor Use in Sweden by Sex and Age: A Drug Utilisation Study.Drug safety · 2025Article
- A Comprehensive 10-Year Nationwide Pharmacovigilance Surveillance on Antibacterial Agents in Korea: Data Mining for Signal Detection of Trends and Seriousness of Adverse Events.Microorganisms · 2025Article
- Clostridioides difficile infection in Saudi Arabia: Prevalence, risk factors, and outcomes in a tertiary hospital setting.PloS one · 2025Article
- Clostridioides difficile infection, recurrence and the associated healthcare consumption in Sweden between 2006 and 2019: a population-based cohort study.BMC infectious diseases · 2024Article
- Clostridioides difficile recurrence in individuals with and without cancer: a Swedish population-based cohort study.Infection · 2024Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundAntibiotics and proton pump inhibitors (PPI) are recognized risk factors for acquisition and recurrence of Clostridioides difficile infection (CDI), yet combined effects remain unclear.
objectivesTo assess the short- and long-term effects of antibiotics and PPIs on CDI risk and recurrence.
methodsPopulation-based study including all 43 152 patients diagnosed with CDI in Sweden (2006-2019), and 355 172 matched population controls without CDI. The impact of antibiotics and PPIs on CDI risk and recurrence was explored for recent (0-30 days) and preceding (31-180 days) use prior to their first CDI diagnosis, using multivariable conditional logistic regression presented as odds ratios (ORs) and 95% confidence interval, adjusted for demographics, comorbidities and other drugs.
resultsCompared to controls, the combined effect of recent PPIs and antibiotics [ORAB+PPI = 17.51 (17.48-17.53)] on CDI risk was stronger than the individual effects [ORAB = 15.37 (14.83-15.93); ORPPI = 2.65 (2.54-2.76)]. Results were less pronounced for exposure during the preceding months. Dose-response analyses showed increasing exposure correlated with CDI risk [recent use: ORAB = 6.32 (6.15-6.49); ORPPI = 1.65 (1.62-1.68) per prescription increase].Compared to individuals without recurrence (rCDI), recent [ORAB = 1.30 (1.23-1.38)] and preceding [ORAB = 1.23 (1.16-1.31); ORPPI = 1.12 (1.03-1.21)] use also affected the risk of recurrence yet without significant interaction between both. Recent macrolides/lincosamides/streptogramins; other antibacterials including nitroimidazole derivates; non-penicillin beta lactams and quinolones showed the strongest association with CDI risk and recurrence, particularly for recent use. PPI use, both recent and preceding, further increased the CDI risk associated with almost all antibiotic classes.
conclusionRecent and less recent use of PPIs and systemic antibiotics was associated with an increased risk of CDI, particularly in combination.
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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.