Wei, L;
Ratnayake, L;
Phillips, G;
McGuigan, CC;
Morant, SV;
Flynn, RW;
Mackenzie, IS;
(2017)
Acid suppression medications and bacterial gastroenteritis: a population-based cohort study.
British Journal of Clinical Pharmacology
, 83
(6)
pp. 1298-1308.
10.1111/bcp.13205.
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Abstract
AIMS: To investigate whether acid suppression medicines (ASMs) increase the risk of bacterial gastroenteritis. METHODS: A population-based, propensity-score matched cohort study using a record-linkage database in Tayside, Scotland. The study consisted of 188,323 exposed to ASMs [proton pump inhibitors (PPIs) and H2 receptor antagonists (H2RA)] and 376,646 controls (a propensity-score matched cohort from the rest of population who were not exposed to ASMs) between 1999 and 2013. The main outcome measure was a positive stool test for C. difficile, Campylobacter, Salmonella, Shigella or Escherichia coli O157. The association between ASMs and risk of bacterial gastroenteritis was assessed by a Cox regression model. RESULTS: There were 22,705 positive test results (15,273 Clostridium difficile (toxin positive), 6,590 Campylobacter, 852 Salmonella, 129 Shigella and 193 Escherichia coli O157, not mutually exclusive) with a total of 5,729,743 person-years follow up time in Tayside, 1999-2013. The adjusted hazard ratios (HRs) for culture positive diarrhoea for the PPIs and H2RA exposed vs unexposed cohort were 2.72 [95% confidence interval (CI) 2.33, 3.17] during follow up time for samples submitted from the community and 1.28 (95% CI 1.08, 1.52) for samples submitted from hospitals. Compared with the unexposed cohort, patients in the exposed group had increased risks of C. difficile and Campylobacter [adjusted HRs of 1.70 (95% CI 1.28, 2.25), 3.71 (95% CI 3.04, 4.53) for community samples, and 1.42 (95% CI 1.17, 1.71), 4.53 (95% CI 1.75, 11.8) for hospital samples, respectively]. CONCLUSIONS: The results suggest that community prescribed ASMs were associated with increased rates of C. difficile and Campylobacter positive gastroenteritis in both the community and hospital settings.
| Type: | Article |
|---|---|
| Title: | Acid suppression medications and bacterial gastroenteritis: a population-based cohort study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/bcp.13205 |
| Publisher version: | http://dx.doi.org/10.1111/bcp.13205 |
| Language: | English |
| Additional information: | Copyright © 2017 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
| Keywords: | acid-suppression medications; bacterial gastroenteritis; cohort study |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1534551 |
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