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Anti-Reflux Drugs, Antibiotics May Raise C. diff Risk

A new study shows that the use of antibiotics and anti-reflux drugs may put patients at increased risk for clostridium difficile infection, the potentially fatal diarrhea bug.

Clostridium difficile infection or C.diff infection, is the leading cause of health care–associated diarrhea, and the bacterium can also be carried asymptomatically. New research shows that approximately 500,000 people in the U.S. become infected with this disease each year.

The objective of this Canadian study was to identify host and bacterial factors associated with health care–associated acquisition of C. difficile infection and colonization.

Researchers conducted a 15-month prospective study in six Canadian hospitals in Quebec and Ontario. Demographic information, known risk factors, potential confounding factors, and weekly stool samples or rectal swabs were collected.

A total of 4,143 patients were included in the study. Of those 117 or 2.8 percent had health-care associated C. difficile infection, while 123 or 3 percent tested positive for the bacteria but showed no symptoms, which is called colonization.

The results of this study demonstrate that people who test positive for North American PFGE type 1 (NAP1) strain of C. difficile are most likely to suffer the symptoms. Patients who don’t develop the common symptoms, are likely infected with other strains of this bug.

Patients who are of older age and use antibiotics, acid-suppressing proton pump inhibitors (PPIs), are at increased risk of C. diff infection.

Hospitalization in the previous two months, use of chemotherapy, acid-suppressing proton-pump inhibitors, and anti-reflux H2 blockers were associated with those who were infected but showed no symptoms.

Researchers explain the increased risk this way. Antibiotics can wipe out bacteria, which can offset the balance between good and bad bacteria in the body, which sets the stage for a C. diff infection.

The risk is different for those who use PPIs such as Prevacid, Nexium, Prilosec, and Protonix. Stomach acid is one of the main defenses against bacteria. But these drugs suppress the stomach acid, which gives bacteria more freedom to run rampant through the body.

"The findings add to the understanding of Clostridium difficile infection and colonization and have implications for prevention and therapy," say the study’s authors, who were led by Dr. Vivian G. Loo, of McGill University Health Center in Montreal.

Symptoms for the potentially fatal C. diff infection include diarrhea, fever, abdominal pain and bleeding. Doctors caution that if you have these symptoms and have been exposed to antibiotics, are taking a PPI, or have been in the hospital or around someone who has, you should call your doctor.

For more information on medical issues, see the library of articles by Daytona Beach nursing home injury attorney.

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