Meta-Analysis
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2017; 23(35): 6500-6515
Published online Sep 21, 2017. doi: 10.3748/wjg.v23.i35.6500
Proton pump inhibitors therapy and risk of Clostridium difficile infection: Systematic review and meta-analysis
Anca Trifan, Carol Stanciu, Irina Girleanu, Oana Cristina Stoica, Ana Maria Singeap, Roxana Maxim, Stefan Andrei Chiriac, Alin Ciobica, Lucian Boiculese
Anca Trifan, Irina Girleanu, Oana Cristina Stoica, Ana Maria Singeap, Roxana Maxim, Stefan Andrei Chiriac, Institute of Gastroenterology and Hepatology, “St. Spiridon” Hospital, “Grigore T. Popa” University of Medicine and Pharmacy, 700111 Iasi, Romania
Carol Stanciu, Institute of Gastroenterology and Hepatology, “St. Spiridon” Hospital, 700111 Iasi, Romania
Alin Ciobica, Department of Research, Faculty of Biology, “Alexandru Ioan Cuza” University of Iasi, 700506 Iasi, Romania
Lucian Boiculese, Department of Preventive Medicine and Interdisciplinarity, “Grigore. T. Popa” University of Medicine and Pharmacy, 700111 Iasi, Romania
Author contributions: Trifan A and Stanciu C designed the study, contributed to the selection of studies, analyzed the data and wrote the manuscript; Stoica OC, Maxim R, Singeap AM, Girleanu I, Chiriac SA and Ciobica A were involved in the acquisition of data and contributed to the analysis and interpretation of data; Girleanu I, Stoica OC, Maxim R and Singeap AM drafted the manuscript; Boiculese L and Girleanu I contributed to the statistical analysis; all authors have read and approved the final version of the manuscript; all authors accept responsibility for its content.
Conflict-of-interest statement: The authors deny any conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Carol Stanciu, MD, FRCP, Professor, Institute of Gastroenterology and Hepatology,“St. Spiridon” Hospital, Independentei Street No. 1, 700111 Iasi, Romania. stanciucarol@yahoo.com
Telephone: +40-722-306020 Fax: +40-232-246611
Received: July 13, 2017
Peer-review started: July 17, 2017
First decision: August 10, 2017
Revised: August 11, 2017
Accepted: August 25, 2017
Article in press: August 25, 2017
Published online: September 21, 2017
Processing time: 69 Days and 23.1 Hours
Core Tip

Core tip: A possible association between the use of proton pump inhibitors (PPIs) and the risk of Clostridium difficile infection (CDI) have been su-ggested by several studies. This meta-analysis, including the largest number of studies published to date found the risk of CDI almost two-times higher in PPIs users than in nonusers. Because all the studies analyzed were observational, the causality could not be confirmed. Nevertheless, clinicians should be aware of such potential association and prescribe the PPIs only where they are clearly indicated.