Proton pump inhibitors and the risk of hospital acquired clostridioides difficile infection in critically ill patients.

Authors

Qian Zeng, Chengfu Guan, Jiana Chen, Li Chen

Published in

Frontiers in pharmacology. Volume 17. Pages 1829764. Epub Jul 13, 2026.

Abstract

Proton pump inhibitors (PPIs) are commonly prescribed medications for critically ill patients. However, the existence of a clear association between PPI prescriptions and Clostridioides difficile infection (CDI) remains controversial. This study aims to investigate the relationship between PPI use and CDI, thereby providing additional evidence for the clinical application of PPIs.
This study extracted data from the eICU and MIMIC IV databases, ultimately enrolling 26,090 patients. Propensity score matching was employed to balance covariates across groups. Clinical outcomes were compared using χ² tests after matching, and specific risk factors were analyzed via multivariate logistic regression, with results presented as odds ratios and 95% confidence intervals.
Compared with the non-PPI group, the PPI group showed a significantly increased risk of CDI (PPI vs. No-PPI: 2.6% vs. 1.6%; OR, 1.70; 95% CI, 1.43-2.02; p < 0.001). Across all subgroups, the risk of CDI was significantly higher in the PPI group than in the non-PPI group. Obesity (BMI ≥ 30), cancer, diabetes, IBD, kidney disease, and use of high-risk antibiotics were significantly associated with increased CDI risk in patients.
Among critically ill patients, PPI recipients exhibited a significantly increased risk of CDI compared to those not using PPIs.

PMID:
42516562
Bibliographic data and abstract were imported from PubMed on 28 Jul 2026.

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