Acid-Suppressing Agents and Risk for Clostridium difficile Infection in Pediatric Patients.

Abstract:

BACKGROUND:Acid-suppressing agents have been associated with increased Clostridium difficile infection (CDI) in adults. The objective of this study was to evaluate the association of acid-suppressing therapy with the development of CDI in the pediatric population. METHODS:This was a retrospective case-control study. Children aged 1 through 17 years with a positive C difficile polymerase chain reaction (PCR) result obtained between June 1, 2008, and June 1, 2012, were randomly matched to a control population selected from patients with negative PCR. RESULTS:A total of 458 children were included. No difference was observed in acid-suppressive therapy prior to PCR in CDI-positive versus -negative patients (n = 131 [57.2%] vs n = 121 [52.8%], P = .348). Among patients receiving acid-suppressing therapy prior to obtaining a PCR, no difference was observed in proton pump inhibitor use (45% vs 46.3%, P = .843), but histamine-2 receptor antagonist (H2RA) use was greater in the CDI-positive patients (32.8% vs 14.9%, P = .001). Logistic regression analysis demonstrated that H2RA therapy at home (odds ratio = 4.6; 95% confidence interval = 1.5-14.5) was an independent CDI predictor. CONCLUSION:In this pediatric population, CDI risk in children receiving home acid-suppressive therapy with H2RAs is nearly 4.5 times greater than that of children not receiving H2RA therapy. These results suggest the need for continued monitoring and study of H2RA therapy in children.

journal_name

Clin Pediatr (Phila)

journal_title

Clinical pediatrics

authors

Brown KE,Knoderer CA,Nichols KR,Crumby AS

doi

10.1177/0009922815569201

subject

Has Abstract

pub_date

2015-10-01 00:00:00

pages

1102-6

issue

11

eissn

0009-9228

issn

1938-2707

pii

0009922815569201

journal_volume

54

pub_type

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