Evidence map›Paper›PMID 42461873›Full record

SynthesisDigestive diseases (Basel, Switzerland)2026

Association between Proton Pump Inhibitor and

Abdul Rafeh Awan, Muniba Ijaz, Meher Ayyazuddin, Anoosh Farooqui, Puneet Kaur Bansal, Mudasar Nisar, Zuhaa Rehman, Abdelrahman M Yousef, Abdullah Ahmad, Jibran Ikram and 6 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Digestive diseases (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

16 authors.

Abdul Rafeh AwanNishtar Medical College, Multan, Pakistan.
Muniba IjazJinnah Hospital, Lahore, Pakistan.
Meher AyyazuddinDepartment of Internal Medicine, Carepoint Bayonne Medical Center, Bayonne, New Jersey, USA.
Anoosh FarooquiUnited Medical and Dental College, Karachi, Pakistan.
Puneet Kaur BansalDigestive Diseases Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Mudasar NisarServices Institute of Medical Sciences, Lahore, Pakistan.
Zuhaa RehmanJinnah Postgraduate Medical Centre, Karachi, Pakistan.
Abdelrahman M YousefDepartment of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.
Abdullah AhmadCMH Medical College, Lahore, Pakistan.
Jibran IkramDepartment of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA.
Antonio GiuseppuciDigestive Diseases Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Sapana VermaDigestive Diseases Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Amir Humza SohailDepartment of Surgical Oncology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.
Asad UllahDepartment of Pathology, Texas Technical University Health Sciences Center, Lubbock, Texas, USA.
Muhammad Ahmad NadeemDigestive Diseases Institute, Cleveland Clinic, Cleveland, Ohio, USA, nadeemm4@ccf.org.
Abu Baker SheikhDepartment of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionClostridioides difficile infection (CDI) is a leading cause of antibiotic-associated diarrhea in critically ill patients. This meta-analysis evaluated whether proton pump inhibitor-based stress ulcer prophylaxis increases CDI risk and examined associated outcomes, including mortality, gastrointestinal bleeding, and other clinical effects in ICU patients.

methodsThe study was prospectively registered on PROSPERO (CRD420251176540). Following PRISMA guidelines, PubMed, Scopus, Cochrane, and Google Scholar were searched (2007 - March 2025) for randomized controlled trials and observational studies comparing PPIs with H

resultsEight studies (∼58,000 patients) met inclusion criteria. PPI use did not significantly increase CDI risk (OR 1.12; p = 0.49, I2 = 73%) or mortality (RR 1.01; p = 0.70) but significantly reduced gastrointestinal bleeding risk (RR 0.60; p = 0.02), particularly versus H

conclusionIn ICU patients, PPI prophylaxis was associated with reduced gastrointestinal bleeding but showed no clear benefit for mortality, ICU or hospital length of stay, or duration of mechanical ventilation. The available evidence does not allow firm conclusions regarding CDI risk because of substantial heterogeneity and very low certainty of evidence. Compared with H2RAs, PPIs provide greater bleeding protection, although possible signals of longer ICU stay and slightly higher mortality require further investigation.

Indexed as

Clostridioides difficileH2RAProton pump inhibitor

Identifiers

PMID42461873
PMCPMC13498313

What OpenQuestion holds

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Registered trials

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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.