The association between histamine 2 receptor antagonist use and Clostridium difficile infection: a systematic review and meta-analysis.

<h4>Background</h4>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.<h4>Purpose</h4>We sought to systematically review the literature that ex...

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Autores principales:	Imad M Tleyjeh, Aref Bin Abdulhak, Muhammad Riaz, Musa A Garbati, Mohamad Al-Tannir, Faisal A Alasmari, Mushabab Alghamdi, Abdur Rahman Khan, Patricia J Erwin, Alex J Sutton, Larry M Baddour
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9605fb969b1e47a4b3afdcb3d74969e9
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spelling	oai:doaj.org-article:9605fb969b1e47a4b3afdcb3d74969e92021-11-18T07:55:09ZThe association between histamine 2 receptor antagonist use and Clostridium difficile infection: a systematic review and meta-analysis.1932-620310.1371/journal.pone.0056498https://doaj.org/article/9605fb969b1e47a4b3afdcb3d74969e92013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23469173/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>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.<h4>Purpose</h4>We sought to systematically review the literature that examined the association between histamine 2 receptor antagonists (H2RAs) and CDI.<h4>Data source</h4>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.<h4>Study selection</h4>Two authors independently reviewed the studies for eligibility.<h4>Data extraction</h4>Data about studies characteristics, adjusted effect estimates and quality were extracted.<h4>Data synthesis</h4>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).<h4>Conclusion</h4>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.Imad M TleyjehAref Bin AbdulhakMuhammad RiazMusa A GarbatiMohamad Al-TannirFaisal A AlasmariMushabab AlghamdiAbdur Rahman KhanPatricia J ErwinAlex J SuttonLarry M BaddourPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 3, p e56498 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Imad M Tleyjeh Aref Bin Abdulhak Muhammad Riaz Musa A Garbati Mohamad Al-Tannir Faisal A Alasmari Mushabab Alghamdi Abdur Rahman Khan Patricia J Erwin Alex J Sutton Larry M Baddour The association between histamine 2 receptor antagonist use and Clostridium difficile infection: a systematic review and meta-analysis.
description	<h4>Background</h4>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.<h4>Purpose</h4>We sought to systematically review the literature that examined the association between histamine 2 receptor antagonists (H2RAs) and CDI.<h4>Data source</h4>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.<h4>Study selection</h4>Two authors independently reviewed the studies for eligibility.<h4>Data extraction</h4>Data about studies characteristics, adjusted effect estimates and quality were extracted.<h4>Data synthesis</h4>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).<h4>Conclusion</h4>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.
format	article
author	Imad M Tleyjeh Aref Bin Abdulhak Muhammad Riaz Musa A Garbati Mohamad Al-Tannir Faisal A Alasmari Mushabab Alghamdi Abdur Rahman Khan Patricia J Erwin Alex J Sutton Larry M Baddour
author_facet	Imad M Tleyjeh Aref Bin Abdulhak Muhammad Riaz Musa A Garbati Mohamad Al-Tannir Faisal A Alasmari Mushabab Alghamdi Abdur Rahman Khan Patricia J Erwin Alex J Sutton Larry M Baddour
author_sort	Imad M Tleyjeh
title	The association between histamine 2 receptor antagonist use and Clostridium difficile infection: a systematic review and meta-analysis.
title_short	The association between histamine 2 receptor antagonist use and Clostridium difficile infection: a systematic review and meta-analysis.
title_full	The association between histamine 2 receptor antagonist use and Clostridium difficile infection: a systematic review and meta-analysis.
title_fullStr	The association between histamine 2 receptor antagonist use and Clostridium difficile infection: a systematic review and meta-analysis.
title_full_unstemmed	The association between histamine 2 receptor antagonist use and Clostridium difficile infection: a systematic review and meta-analysis.
title_sort	association between histamine 2 receptor antagonist use and clostridium difficile infection: a systematic review and meta-analysis.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/9605fb969b1e47a4b3afdcb3d74969e9
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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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