This article examines the relationship between acid-suppressive therapy and Clostridium difficile infection. C difficile infection is increasingly common in the United States, with annual medical costs over $1 billion, and is primarily spread as a hospital-acquired infection. It has been speculated that acid-suppressive therapy such as proton pump inhibitors and histamine-receptor antagonists may lead to increased rates of C difficile infection, but this theory has not been confirmed by prior research.
The authors performed a pharmacoepidemiologic cohort study that analyzed data from 101,796 patients discharged between 2004 and 2008 from a large, urban, tertiary care center. Of these patients, 665 (0.7%) had a C difficile infection.
While this study cannot prove that increasing acid-suppressive therapy causes increased levels of hospital-acquired C difficile infection, it provides strong evidence in favor of this theory.