ReviewAssociation Between Proton Pump Inhibitor Therapy and Clostridium difficile Infection in a Meta-Analysis
Section snippets
Methods
All procedures used in this meta-analysis were consistent with Preferred Reporting Items for Systematic reviews and Meta-analyses guidelines.8
Study Characteristics
Of the 688 references identified, 109 potentially relevant citations were selected based on relevance to the study topic. After screening all the titles and abstracts, 51 articles were selected for full-text review (Figure 1). Twenty-nine articles that reported PPI therapy and CDI published between 1990 and 2010 were included in the meta-analysis. Twenty-two articles were excluded (reasons for exclusion are listed in Figure 1). Table 1 summarizes the main characteristics of the included
Discussion
We found an association between CDI and PPI therapy in our meta-analysis involving 30 studies and 202,965 patients. Overall, patients on PPI therapy have approximately twice the risk of developing CDI compared with nonusers. However, the significant heterogeneity amongst the studies implies that the summary OR should be interpreted with caution. On subgroup and sensitivity analyses, the positive association between PPI therapy and the risk of CDI remained; significant heterogeneity persisted
Acknowledgments
A.D., C.P., and V.P. contributed equally to this work.
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Conflicts of interest The authors disclose no conflicts.