Overuse of PPIs linked to C difficile infection risk

GPs should limit their prescribing of proton pump inhibitors (PPIs) because the treatment could increase the risk of Clostridium difficile infection.

The warning comes after UK research revealed that 64 per cent of patients who developed C difficile were on PPIs, although only 38 per cent met NICE criteria.

The study involved 138 hospitalised patients diagnosed with C difficile infection over a four-month period. While 88 patients were found to be on PPIs, 75 of who had been prescribed the drugs by their GP.

Under NICE guidance, patients should be given PPIs for two to four weeks for uninvestigated dyspepsia or one to two months for gastro-oesophageal reflux disease.

But these indications were found in just 34 of the patients on PPIs. Five patients had continued to receive PPIs after clearing the infection.

The researchers from Manchester Royal Infirmary conclude that ‘there appears to be widespread and inappropriate use of PPIs', and call for better adherence to NICE guidance.


Q J Med Online 2008

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