Stomach acid drugs raise risk of C. diff

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Stomach acid is often treated with medications such as Pepcid, but that could put long-term care residents or hospitalized patients at risk for Clostridium difficile, according to a new analysis.

Mayo Clinic researchers focused on histamine 2 receptor antagonists. In a review of 33 studies, they found a clear association between the histamine 2 receptor antagonists' use to treat stomach acid and C. diff. The theory, according to senior author and infectious disease specialist Larry Baddour, M.D., is vegetative forms of C. diff normally killed by stomach acid survive when a patient ingests a stomach acid suppressor. That can lead to a fatal C. diff infection.

“The extent of gastric acid suppression could play an important role in potentiating the risk of infection,” the authors noted in PLoS One in March.

However, the risk of infection was highest in hospitalized patients receiving antibiotics, and very low for the those taking over-the-counter medications such as Zantac. Reducing the use of these drugs in hospitalized patients may significantly reduce their risk of C. diff, researchers said.In 2012, the Food and Drug Administration warned that stomach acid drugs called proton pump inhibitors had been associated with C.diff.