17 responses to “Proton pump inhibitors and Clostridium difficile infection”

  1. Thank you

  2. Timely article as we have been reviewing in our ED c. difficile hygiene management. Thank you. I will be more “aware” of my PPI prescribing based on this article.

  3. Good advice. It is easy to forget the hazards of medication.

  4. Good idea to look at cost/benefit ratio of PPI’s initially as inpatient, on discharge fm hospital, as well as on review post discharge.

  5. Good advice, it is an issue I am not aware.

  6. I look after hospitalized cancer patients with complications during and after chemotherapy or radiation. Many of these patients are needing steroids, antibiotics, and PPI’s. So far I haven’t had a patient with a GI bleed complicating their course. I would be reluctant to substitue H2 blockers for PPI’s in this patient population. Cl diff diarrhea does occur, but seems quite manageable in my experience to date. Seems to respond to metronidazole quite promptly. I will try to stop PPI’s on discharge, and replace with H2 blockers, after the acute illness.

  7. I agree PPI has been overprescribed for a longtime. I have been telling my patients who take PPI daily for occasional heartburn to stop the daily use. Sometime successful other times not. As PPI and antibiotic are 2 of the commonest prescribed medications we are bound to run into this C diff scenerio more often. Excellent advice

  8. thank you, I deal with CDI all the time in the hospital, will look carefully at the need of PPIs now.

  9. Good reminder. Sometimes in the ICU setting, when a patient has a mortality risk with bleeding ulcers, one has to balance the risk of bleeding and risk of developing C. Diff problems.

  10. Have been aware that PPI use is associated with susceptibility to gastroenteritis but not to C. Deficile specifically. Thanks for the information.

  11. as in the daily practice we, as health care provider, have come across so many cases of G-I problem that PPI and H2 inkibitor have been great demand to start on our patients. However there is some grey areas for the use of these drugs, base on symptomatic vs actual pathological indication. the possibility of increasing CDI would be another precaution in consideratio for using these anti-secretory med.for our patients.

  12. Thank you. I have been quite suspicious of all the PPI promotion. Now a new worry.

  13. Thank You.Good reasons for therapeutic rethink.

  14. Thanks, with the recent media coverage of c.diff “outbreaks” the public is more aware and also aware of the relationship to antibiotics. This is a new issue for me and valuable information

  15. Thank You. These study results are a reminder to thoughtfully consider the need for PPI and or H2 Blocker therapy in hospitalised patients, and whenever possible to discontinue these agent when CDI is confirmed.

  16. Thank you. This will be another piece of information to pass on to patienet as I encourage them to do more behavioural modification and step down off PPI once symptoms have been successfully controlled.

  17. Thank-you. Anything that we can do to help control and prevent CDI is useful.

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