- Poster presentation
- Open Access
Proton pump inhibitors and the incidence of Clostridium difficile on the intensive care unit
© BioMed Central Ltd. 2007
- Published: 22 March 2007
- Intensive Care Unit
- Gastric Acid
- Proton Pump Inhibitor
- Faecal Sample
Clostridium difficile associated disease (CDAD) is recognized as a major cause of morbidity and mortality among patients in hospital. There have been reported associations between the use of proton pump inhibitors (PPIs) and CDAD in community and hospital settings [1, 2]. The aim of this study was to investigate the effect of introducing PPI prophylaxis in critically ill patients on the incidence of CDAD.
Retrospective analysis of microbiology results of patients admitted to general and neurotrauma ICUs between February 2002 and September 2006. Prior to March 2004 the general ITU used PPIs for all patients as gastric acid prophylaxis, and the neurotrauma ITU used PPIs for only patients at high risk of GI ulceration. Following instigation of ventilator care bundles in March 2004 both units gave PPIs to all ventilated patients. The incidence of C. difficile toxin-positive samples and the number of doses of PPI used each month were compared for before and after this time period. The use of antibiotics was also compared between the two units over the time period to exclude this as a confounding variable.
C. difficile rates have remained relatively stable on the general ITU (ITU2) but showed a significant increase on the neurotrauma ITU (ITU3), concurrent with increased PPI usage. We believe this worthy of further investigation.
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