Acid-Decreasing Drugs Increase Risk of C. diff Infection in Children

Infants and young children who were prescribed acid-reducing drugs were found to face a higher risk of developing Clostridium difficile (C. diff) infection.

Study results reported by researchers from Columbia University Medical Center (CUMC) were recently published in the online edition of Clinical Infectious Diseases.

Commenting on the topic of acid-reducing treatment, Daniel E. Freedberg, MD, MS, assistant professor of medicine, CUMC, remarked, “There’s no question that acid-reducing medications alleviate heartburn in adults, but there’s little evidence of benefit in healthy infants and younger children.”

Freedberg continued, “Given our findings about the risk involved, pediatricians may hesitate before prescribing these drugs unless there is evidence of acid-related disease.”

Previous studies had indicated that medications like proton pump inhibitors (PPIs) contribute to C. diff. infection in adults. And, as PPI use has steadily grown over the years, Freedberg and his colleagues were compelled to study whether the same relationship existed in pediatric patients.

As such, the study focused on whether the use of PPIs and another common type of acid-reducing drug, histamine-2 receptor antagonists (H2RAs), could also be contributing to the increase in the number of C. diff. infections in children who had yet to exhibit any known risk factors.

Examining 650 children’s health records in The Health Improvement Network, the researchers found that 2.6% of children diagnosed with C. diff infections had actually used PPIs/H2RAs within 90 days as opposed to the 0.3% of placebo group.

Essentially, the study noted the use of acid-reducing medication contributed to a seven-fold increase in the risk of C. diff infections — likely by modifying the gastrointestinal microbiome.