People taking drugs for heartburn such as proton pump inhibitors are more prone to getting a potentially dangerous diarrhoea caused by the bacterium Clostridium difficile, according to researchers at Canada's McGill University.
C difficile can cause severe diarrhea and colitis, and in severe cases can lead to or contribute to death. It is typically a disease that affects patients in hospital, usually after they have been given antibiotic therapy. But the new study also suggests that the character of the infection is changing, with community-acquired cases increasingly common.
The McGill researchers examined data on more than 18,000 patients in the UK from 1994 to 2004. They found that from the rate of cases in the community rose steadily, from about one case per 100,000 at the start to 22 per 100,000 at the end of the period.
Over 70% of the patients who developed C difficile-associated disease had not been admitted to hospital in the past year, and less than 50% had taken antibiotics in the three months prior to developing disease.
Patients using PPIs such as AstraZeneca’s Nexium (esomeprazole) or Takeda’s Zoton (lansoprazole) were almost three times more likely to be diagnosed with C difficile than those not taking the drugs. Those on less potent acid-suppressing therapy - H2 receptor antagonists such as famotidine and ranitidine - were twice as likely as non-users to contract the infection.
The researchers suggest that acid-suppressing drugs make it easier for C difficile to survive in the gastrointestinal tract.
Meanwhile, a report from the UK’s Health Protection Agency and Healthcare Commission has also rung a warning bell over C difficile, concluding that National Health Service trusts are failing to use measures designed to control the spread of the infection.
The report suggests that up to a third of NHS trust are failing to follow official guidelines on measures to reduce risk, including careful use of antibiotics and isolating infected patients, according to a BBC report.
The first set of data from a mandatory reporting scheme last year showed there had been over 44,000 cases of the infection in hospitals in England - a 98% increase from 2001.