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Clostridium difficile–associated disease (CDAD) is becoming more common and more severe, both in hospitals and in the community (Journal Watch Dec 20 2005). To determine whether rising rates of gastric-acid–suppressive therapy in the community might be partially responsible, researchers used a database of primary care patients in Great Britain. The database included 1672 patients who were diagnosed with CDAD from 1994 through 2004.
During the study period, the annual rate of disease rose more than 20-fold, use of proton-pump inhibitors (PPIs) increased, and antibiotic use actually decreased slightly. In a case-control analysis, older age, prior hospitalization, and antibiotic use all correlated strongly with increased risk for CDAD. Among th…