The association between histamine 2 receptor antagonist use and Clostridium difficile infection: a systematic review and meta-analysis..pdf (944.58 kB)
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The Association between Histamine 2 Receptor Antagonist Use and Clostridium difficile Infection: A Systematic Review and Meta-analysis

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posted on 14.07.2015, 12:48 by I. M. Tleyjeh, A. B. Abdulhak, M. Riaz, M. A. Garbati, M. Al-Tannir, F. A. Alasmari, M. Alghamdi, A. R. Khan, P. J. Erwin, A. J. Sutton, L. M. Baddour
BACKGROUND: Clostridium difficile infection (CDI) is a major health problem. Epidemiological evidence suggests that there is an association between acid suppression therapy and development of CDI. PURPOSE: We sought to systematically review the literature that examined the association between histamine 2 receptor antagonists (H2RAs) and CDI. DATA SOURCE: We searched Medline, Current Contents, Embase, ISI Web of Science and Elsevier Scopus from 1990 to 2012 for all analytical studies that examined the association between H2RAs and CDI. STUDY SELECTION: Two authors independently reviewed the studies for eligibility. DATA EXTRACTION: Data about studies characteristics, adjusted effect estimates and quality were extracted. DATA SYNTHESIS: Thirty-five observations from 33 eligible studies that included 201834 participants were analyzed. Studies were performed in 6 countries and nine of them were multicenter. Most studies did not specify the type or duration of H2RAs therapy. The pooled effect estimate was 1.44, 95% CI (1.22-1.7), I(2) = 70.5%. This association was consistent across different subgroups (by study design and country) and there was no evidence of publication bias. The pooled effect estimate for high quality studies was 1.39 (1.15-1.68), I2 = 72.3%. Meta-regression analysis of 10 study-level variables did not identify sources of heterogeneity. In a speculative analysis, the number needed to harm (NNH) with H2RAs at 14 days after hospital admission in patients receiving antibiotics or not was 58, 95% CI (37, 115) and 425, 95% CI (267, 848), respectively. For the general population, the NNH at 1 year was 4549, 95% CI (2860, 9097). CONCLUSION: In this rigorous systematic review and meta-analysis, we observed an association between H2RAs and CDI. The absolute risk of CDI associated with H2RAs is highest in hospitalized patients receiving antibiotics.

History

Citation

PLoS One, 2013, 8 (3), e56498

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Health Sciences

Version

VoR (Version of Record)

Published in

PLoS One

Publisher

Public Library of Science

eissn

1932-6203

Acceptance date

10/01/2013

Copyright date

2013

Available date

14/07/2015

Publisher version

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0056498

Notes

Correction: 2 Apr 2013: Tleyjeh IM, Abdulhak AAB, Riaz M, Garbati MA, Al-Tannir M, et al. (2013) Correction: The Association between Histamine 2 Receptor Antagonist Use and Clostridium difficile Infection: A Systematic Review and Meta-analysis. PLoS ONE 8(4): 10.1371/annotation/56f8945c-33f6-45bf-87ce-dd512f7c25b0 Available at http://journals.plos.org/plosone/article?id=10.1371/annotation/56f8945c-33f6-45bf-87ce-dd512f7c25b0

Language

en