Type of Document Thesis Author Scott, Jennifer Haith Author's Email Address firstname.lastname@example.org URN etd-04022007-200224 Title Association between Concurrent Use of Proton Pump Inhibitors and Antibiotic Therapies with Increasing Incidence of Clostridium Difficile Infections. Degree Master of Science Department Nursing, School of Advisory Committee
Advisor Name Title Laurie Grubbs Committee Chair Sandra Faria Committee Member Susan Porterfield Committee Member Keywords
- Medication Regimens
- Gastrointestinal Infections
- Nosocomial Infections
- Community Acquired Infections
Date of Defense 2007-03-20 Availability unrestricted AbstractClostridium difficile (C. difficile) is an important cause of nosocomial infection and is rapidly becoming a community-acquired infection. Recently, however, it has been suggested that the addition of proton pump inhibitors (PPIs) to the patientís medication regimen may be responsible for the overgrowth of C. difficile in the GI system (Dial, Delaney, Barkun & Suissa, 2005). Health care providers (HCPs) must understand the triggers for this infection in order to better serve their patientís needs and must also understand the best practices when prescribing medications to their patients.
The purpose of this study was to determine if there was an association between increasing incidences of C. difficile infections and concurrent use of proton pump inhibitors with antibiotic therapies. The sample for this retrospective study included 130 patients who were diagnosed with C. difficile during hospitalization between January 1, 2003 and January 1, 2007. The medical record of the study subjects included the following data: age, gender, race, length of stay, antibiotic therapy, proton pump inhibitor therapy, lab diagnosis of Clostridium difficile, co-morbid conditions, home medication lists, and the medications prescribed in the hospital.
Though this study was unable to determine any relation between the use of PPIs with age, gender, length of stay, and C. difficile infections, some interesting trends were noted. Only 13.1% of the sample population had been diagnosed with gastroesophageal reflux disease (GERD), 6.2% had gastroenteritis, 12.3% had colitis, and 5.4% had diverticulosis. These diagnoses are usually the primary reasons proton pump inhibitors are prescribed yet the low numbers of these diagnoses in the sample and the high rate of PPI prescriptions is noteworthy. There were higher uses of proton pump inhibitors in patients with congestive heart failure (29.2%), diabetes (23.1%), hypertension (51.5%), and COPD (30.0%). There was a significant difference between observed and expected frequencies, in other words, the proportion of patients using proton pump inhibitors was statistically higher than those who did not use them (significant chi square Ė p value = .003). Increased prescriptions of proton pump inhibitors to patients with more complicated disease processes needs to be studied.
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