| Reference |
Type of study |
Study description |
Strength of association (with 95% CI*,†) |
Comments |
| (90) |
Hospital based |
Case control study: 126 cases and 126 controls |
0.9 (0.5–1.5)‡ |
An association between PPI use and CDI was not seen in a group of elderly subjects. |
| (91) |
Hospital based |
Case control study: 27 cases and 27 controls |
3.0 (0.8–11.0) |
H2 blockers§ were also evaluated and showed no significant association. |
| (92) |
Hospital based |
Case control study: 160 cases and 160 controls |
2.5 (1.5–4.2) |
PPI use the preceding 8 weeks was associated with increase in CDI risk. |
| (93) |
Hospital based |
Cohort study: 1,187 subjects |
2.1 (1.2–3.5) |
H2 blockers were also evaluated and showed no significant association. |
| (93) |
Hospital based |
Case control study: 94 cases and 94 controls |
2.7 (1.4–5.2) |
Patients in the hospital who received PPIs were at increased risk for CDI. |
| (94) |
Community based |
Case control study: 1,233 cases and 12,330 controls |
2.9 (2.4–3.4) |
H2 blockers were also evaluated and showed significant association. |
| (95) |
Hospital based |
Case control study: 203 cases and 203 controls |
2.4 (1.3–4.4) |
Hospital outbreak of CDI was studied. |
| (96) |
Hospital based |
Case control study: 50 cases and 200 controls |
3.4 (1.7–6.8) |
H2 blockers were also evaluated and showed no significant association. |
| (59) |
Hospital based |
Retrospective cohort study: 5,619 subjects |
1.0 (0.8–1.3) |
H2 blockers were also evaluated and showed no significant association. |
| (97) |
Community based |
Case control study: 317 cases and 3,167 controls |
3.5 (2.3–5.2) |
Cases of CDI were identified by first identifying oral use of vancomycin. |
| (98) |
Hospital-based |
Case control study: 64 cases and 128 controls |
5.0 (1.3–19.4) |
Hospital outbreak of CDI cases was studied. |
| (99) |
Community based |
Population based nested case control study: 1389 cases and 12 303 controls |
0.9 (0.8–1.1) |
Study in old age patients, age ≥ 66 years. |
| (57) |
Hospital based |
Case control study: 155 cases and 153 controls |
1.9 (1.1–3.3) |
PPI use in the preceding 3 months was associated with increase in CDI risk. |
| (100) |
Hospital based |
Case control study: 640 cases and 650 controls |
1.7 (1.4–2.2) |
Study in African American and Hispanics population. |
| (58) |
Hospital based |
Cohort study: 827 subjects |
0.9 (0.6–1.4) |
Mean duration of PPI use was 8.9 days. H2 blockers were also evaluated and showed no significant association. |
| (101) |
Hospital based |
Retrospective cohort study: 36 086 subjects |
1.6 (1.3–2.1) |
H2 blockers were also evaluated and showed significant association. |
| (102) |
Hospital based |
Nested Case control study: 382 cases and 1,528 controls |
4.1 (3.2–5.2) |
H2 blockers were also evaluated showing significant association. |
| (103) |
Hospital based |
Case control study: 122 cases and 244 controls |
2.8 (1.7–4.5) |
H2 blockers were also evaluated and showed no significant association. |
| (104) |
Hospital based |
Case control study: 184 cases and 184 controls |
0.8 (0.5–1.4)‡ |
H2 blockers were also evaluated and showed no significant association. |
| (105) |
Hospital based |
Case control study: 94 cases and 94 controls |
3.6 (1.7–8.3) |
Environmental factors were controlled between case and control subjects. H2 blockers were also evaluated and showed no significant association. |
| (106) |
Hospital based |
Case control study: 1142 cases and 3351 controls |
1.2 (1.03–1.5) |
Use of PPI in the 60 days before index date was associated with increased risk of CDI. |
| (107) |
Hospital based |
Retrospective cohort study: 14 719 subjects |
2.0 (1.4–2.7) |
The increased risk of acquiring CDI with PPI use in the hospital relates to the frequency of CDI in the population. |
| (108) |
Community based |
Nested case control study: 836 cases and 8360 controls |
1.6 (1.3–2.0) |
H2 blockers were also evaluated and showed significant association. Older age patients, age ≥ 65 years studied. |
| (109) |
Community based |
Case control study: 40 cases and 112 controls |
1.1 (0.1–7.2)‡ |
The study reported only 2 cases of PPI users among cases of CDI. |
| (110) |
Hospital based |
Case control study: 45 cases and 90 controls |
1.1 (0.5–2.6) |
The various risk factors for hospital acquired CDI were evaluated. |
| (111)
|
Hospital based |
Prospective Case control study: 93 cases and 76 controls |
1.1 (0.5–2.6) |
Studied the risk factors for CDI in an endemic setting. |
| (19) |
Hospital based |
Cohort study: 1 01 796 subjects |
For daily PPI use: 1.7 (1.4–2.2) More frequent than daily PPI use: 2.4 (1.8–3.1) |
H2 blockers were also evaluated and showed significant association The authors identified the combination of acid suppression and antibiotic exposure as the principal risk factors for CDI. |