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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, African Continental Ancestry Group, Age Factors, Antacids, Anti-Bacterial Agents, Case-Control Studies, Child, Child, Preschool, Clostridium difficile, Enterocolitis, Pseudomembranous, European Continental Ancestry Group, Gastric Acid, Humans, Infant, Inpatients, Odds Ratio, Outpatients, Proton Pump Inhibitors, Retrospective Studies, Risk Factors, Tertiary Care Centers, United States.
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Does exposure to Gastric Acid-Suppression Therapy be Associated With Health Care- and Community-Associated Clostridium difficile Infection in Children? Context: The aim of the study was to determine whether gastric acid-suppression therapy is associated with Clostridium difficile infection (CDI) in both inpatient and outpatient pediatric populations. We conducted a retrospective case-control study at a 200-bed academic pediatric hospital and associated outpatient clinics during 2005-2010. We defined cases as children 1 to 18 years of age with a first positive test for C difficile toxin A/B, and matched each case to 2 controls without C difficile. We conducted chart review to elicit selected comorbidities and exposure to gastric acid-suppression therapy and antibiotics in the preceding 3 months of the infection or encounter date. We used bivariate and multivariable logistic regression to evaluate the association between antacid use and CDI, controlling for potential confounders. We identified 138 children with health care- or community-associated CDIs and 276 controls. The use of any acid suppression therapy was more common in cases compared with controls (34% vs 20%, P = 0.002). When adjusted for demographic variables and comorbidities, gastric acid-suppression therapy remained significantly associated with CDI (adjusted odds ratio [aOR] 1.8, 95% confidence interval [CI] 1.0-3.1). Antibiotic use (aOR 1.7, 95% CI 1.1-2.7) and immunosuppressed state were also associated with CDI in our adjusted model (aOR 2.5, 95% CI 1.2-5.2).
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Gastric acid-suppression therapy was associated with both health care- and community-associated CDIs in children. Larger pediatric studies are necessary to determine the role of proton pump inhibitors specifically in causing CDI in children. Final Decision: yes