TY - JOUR
T1 - Proton pump inhibitors and risk of Clostridium difficile infection
T2 - a multi-country study using sequence symmetry analysis
AU - Roughead, Elizabeth E.
AU - Chan, Esther W.
AU - Choi, Nam Kyong
AU - Griffiths, Jenna
AU - Jin, Xue Mei
AU - Lee, Joongyub
AU - Kimura, Michio
AU - Kimura, Tomomi
AU - Kubota, Kiyoshi
AU - Lai, Edward Chia Cheng
AU - Man, Kenneth K.C.
AU - Nguyen, Tuan Anh
AU - Ooba, Nobuhiro
AU - Park, Byung Joo
AU - Sato, Tsugumichi
AU - Shin, Ju Young
AU - Wang, Tong Tong
AU - Wong, Ian C.K.
AU - Yang, Yea Huei Kao
AU - Pratt, Nicole L.
N1 - Publisher Copyright:
© 2016 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Objective: To determine the association between incident proton pump inhibitor (PPI) use and Clostridium difficile infections across multiple countries Method: National data covering the total population in Australia and Korea, the Canadian population over 65 years and a 3 million person random sample data set from Taiwan were assessed, as were data from a worker insurance population and a hospital inpatient/outpatient population in Japan. Sequence symmetry analysis was used to assess the association with oral vancomycin dispensing as the outcome of interest. Results: 54,957 patients were included. Positive associations were observed in Australia; adjusted sequence ratio (ASR) 2.48 (95% CI 1.90, 3.12), Korea ASR 2.15 (95%CI 2.11, 2.19), Canada ASR 1.45 (95% CI 1.16, 1.79), Japan hospital dataset ASR 3.21 (95%CI 2.12, 4.55) and Japan worker insurance dataset ASR 5.40 (95% CI 2.73, 8.75). The pooled result was ASR 2.40 (95%CI 1.88, 3.05) and 3.16 (95%CI 1.95, 5.10) when limited to Japan, Korean and Taiwan. Results did not vary by individual PPI. The temporal analysis showed effects within the first two weeks of PPI initiation. Conclusion: Our study confirms the association between PPI initiation and C. difficile infections across countries in the Asia-Pacific region.
AB - Objective: To determine the association between incident proton pump inhibitor (PPI) use and Clostridium difficile infections across multiple countries Method: National data covering the total population in Australia and Korea, the Canadian population over 65 years and a 3 million person random sample data set from Taiwan were assessed, as were data from a worker insurance population and a hospital inpatient/outpatient population in Japan. Sequence symmetry analysis was used to assess the association with oral vancomycin dispensing as the outcome of interest. Results: 54,957 patients were included. Positive associations were observed in Australia; adjusted sequence ratio (ASR) 2.48 (95% CI 1.90, 3.12), Korea ASR 2.15 (95%CI 2.11, 2.19), Canada ASR 1.45 (95% CI 1.16, 1.79), Japan hospital dataset ASR 3.21 (95%CI 2.12, 4.55) and Japan worker insurance dataset ASR 5.40 (95% CI 2.73, 8.75). The pooled result was ASR 2.40 (95%CI 1.88, 3.05) and 3.16 (95%CI 1.95, 5.10) when limited to Japan, Korean and Taiwan. Results did not vary by individual PPI. The temporal analysis showed effects within the first two weeks of PPI initiation. Conclusion: Our study confirms the association between PPI initiation and C. difficile infections across countries in the Asia-Pacific region.
KW - Asia
KW - Clostridium difficile
KW - Proton pump inhibitors
KW - adverse event
KW - sequence symmetry analysis
UR - http://www.scopus.com/inward/record.url?scp=84988693947&partnerID=8YFLogxK
U2 - 10.1080/14740338.2016.1238071
DO - 10.1080/14740338.2016.1238071
M3 - Article
C2 - 27645304
AN - SCOPUS:84988693947
SN - 1474-0338
VL - 15
SP - 1589
EP - 1595
JO - Expert Opinion on Drug Safety
JF - Expert Opinion on Drug Safety
IS - 12
ER -