title: Risk factors for recurrence of clostridium difficile-associated diarrhoea.
abstract: OBJECTIVE
  Clostridium difficile associated disease (CDAD) is one of the most common causes of hospital-acquired diarrhea. Despite increasing incidence of clostridium difficile-associated diarrhea, there are few data on risk factors associated with its relapse.
  
  
  METHODS
  We studied retrospectively possible risk factors for the recurrence of CDAD; 124 patients fulfilled the criteria of CDAD during the study period between January 2006 and July 2009. After successful treatment, recurrence occurred in 20 patients.
  
  
  RESULTS
  Nineteen patients (95%, p = 0.029) in the relapse group were on long term proton pump inhibitor therapy compared to 77 patients (74%) in the non-relapse group. There was no statistically significant difference in severity (CRP: p = 0.442, leucocytosis: p = 0.415) and length of hospitalization (p= 0.539) in both studied groups; however, CDAD-relapse was associated with more hospital readmissions and increased health care costs.
  
  
  CONCLUSIONS
  Proton pump inhibitor therapy may be associated with increased risk of recurrence of CDAD, and represents a relevant, yet correctable risk factor. In patients at risk for CDAD, proton pump inhibitors should be used carefully.
authors.forename: Ahmed Abdel
authors.initials: AA
authors.lastname: Samie
authors.forename: Marc
authors.initials: M
authors.lastname: Traub
authors.forename: Klaus
authors.initials: K
authors.lastname: Bachmann
authors.forename: Karolin
authors.initials: K
authors.lastname: Kopischke
authors.forename: Lorenz
authors.initials: L
authors.lastname: Theilmann
mesh_terms: D000368:Aged; D003967:Diarrhea / Q000209:etiology*; D004761:Enterocolitis, Pseudomembranous / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000009:adverse effects; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D054328:Proton Pump Inhibitors