RT Journal
A1 Famularo G, Gasbarrone L, De Simone C
T1 PRoton pump inhibitors and the risk for clostridium difficile infection
JF JAMA
JO JAMA
YR 2009
FD July 1
VO 302
IS 1
SP 31
OP 32
DO 10.1001/jama.2009.901
UL http://dx.doi.org/10.1001/jama.2009.901
AB 
The inhibition of gastric acid secretion by PPIs could be an important mechanism in the increasing incidence of CDI because it is thought to suppress a fundamental physiologic defense mechanism against ingested bacteria and spores. The vegetative form of C difficile has been shown to survive in gastric contents with a raised pH,3 which could explain why patients using PPIs may be prone to colonization with C difficile. This is supported by the experimental finding that the risk of acquiring active CDI and the severity of the resulting colitis are similar when animals are exposed to either PPIs or antibiotics.4 However, it is unclear whether giving PPIs to patients who are also taking antibiotics could further increase the susceptibility to CDI; more well-designed epidemiologic studies are needed to assess this hypothesis.