A new study suggests judicious use of antibiotics and proton pump inhibitors (PPIs) may help reduce the risk of Clostridium difficile infection (CDI) in paediatric inpatients.
The meta-analysis and systematic review, published in the journal Infection Control and Hospital Epidemiology, evaluated risk factors for CDI in hospitalised paediatric patients as determined by previous observational studies. Of 2,033 articles screened, 14 studies reporting 10,531,669 children met the inclusion criteria.
Analysis of studies reporting adjusted data on prior antibiotic exposure showed an increased risk of CDI with prior exposure to antibiotics, but the results were not statistically significant (OR 1.49; 95% CI 0.66-3.34; P=.34). Risk factors for CDI with individual antibiotic sub-classes were not reported by more than two studies and therefore not included in the meta-analysis.
Meta-analysis of four studies showed increased risk of CDI with PPI use (OR 1.33; 95% CI 1.07-1.64; P=.01). Meta-analysis of three studies examining H2 receptor antagonist (H2RA) use also showed increased risk of CDI associated with H2RA use, but the result was not statistically significant (OR 1.36; 95% CI 0.31-5.98; P=.68).
“Clinicians should continue to utilise antibiotics judiciously in hospitalised patients to minimise the risk for CDI, and similar considerations may be beneficial prior to administration of PPIs,” the authors advise.