Proton pump inhibitors and risk of Clostridium difficile infection: a multi-country study using sequence symmetry analysis. Issue 12 (1st December 2016)

• Record Type: Journal Article
• Authors: Roughead, Elizabeth E; Chan, Esther W; Choi, Nam-Kyong; Griffiths, Jenna; Jin, Xue-Mei; Lee, Joongyub; Kimura, Michio; Kimura, Tomomi; Kubota, Kiyoshi; Lai, Edward Chia-Cheng; Man, Kenneth KC; Nguyen, Tuan Anh; Ooba, Nobuhiro; Park, Byung-Joo; Sato, Tsugumichi; Shin, Ju-Young; Wang, TongTong; Wong, Ian CK; Yang, Yea-Huei Kao; Pratt, Nicole L
• Is Part Of: Expert opinion on drug safety. Volume 15:Issue 12(2016)
• Page Start: 1589
• Page End: 1595
• Publication Date: 2016-12-01
• Subjects: Proton pump inhibitors -- Clostridium difficile -- adverse event -- Asia -- sequence symmetry analysis; Drugs -- Side effects -- Periodicals; Drugs -- Toxicology -- Periodicals; Chemotherapy -- Periodicals; 615.704
• DOI: 10.1080/14740338.2016.1238071
• Languages: English
• ISSNs: 1474-0338

Abstract

ABSTRACT: Objective: To determine the association between incident proton pump inhibitor (PPI) use and Clostridium difficile infections across multiple countries Method: National data covering the total population in Australia and Korea, the Canadian population over 65 years and a 3 million person random sample data set from Taiwan were assessed, as were data from a worker insurance population and a hospital inpatient/outpatient population in Japan. Sequence symmetry analysis was used to assess the association with oral vancomycin dispensing as the outcome of interest. Results: 54, 957 patients were included. Positive associations were observed in Australia; adjusted sequence ratio (ASR) 2.48 (95% CI 1.90, 3.12), Korea ASR 2.15 (95%CI 2.11, 2.19), Canada ASR 1.45 (95% CI 1.16, 1.79), Japan hospital dataset ASR 3.21 (95%CI 2.12, 4.55) and Japan worker insurance dataset ASR 5.40 (95% CI 2.73, 8.75). The pooled result was ASR 2.40 (95%CI 1.88, 3.05) and 3.16 (95%CI 1.95, 5.10) when limited to Japan, Korean and Taiwan. Results did not vary by individual PPI. The temporal analysis showed effects within the first two weeks of PPI initiation. Conclusion: Our study confirms the association between PPI initiation and C. difficile infections across countries in the Asia-Pacific region.