Use of PPIs, H2-blockers, and NSAIDs increase risk for C. difficile–associated disease, but the mechanism underlying these effects remains unknown.
Recent reports have demonstrated that both the prevalence and severity of Clostridium difficile–associated diarrhea (CDAD) are increasing. Given that gastric acidity provides a major defense mechanism against ingested pathogens, concerns have been raised that suppressing such acidity might facilitate colonization of the normally sterile upper gastrointestinal tract. The aim of this population-based, case-control study was to investigate whether widespread use of acid-suppressant medications might be correlated with increasing prevalence of community-acquired CDAD.
Investigators used the United Kingdom General Practice Research Database to identify 1233 cases of CDAD for which patients were not hospitalized in the year preceding diagnosis. Af…