Proton Pump Inhibitor Use and Associated Infectious Complications in the PICU: Propensity Score Matching Analysis.
Pediatr Crit Care Med 2022;
23:e590-e594. [PMID:
35994620 DOI:
10.1097/pcc.0000000000003063]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES
We aimed to evaluate the association between proton pump inhibitor (PPI) exposure and nosocomial infection (NI) during PICU stay.
DESIGN
Propensity score matched analysis of a single-center retrospective cohort from January 1, 2017, to December 31, 2018.
SETTING
Tertiary medical and surgical PICU in France.
PATIENTS
Patients younger than 18 years old, admitted to the PICU with a stay greater than 48 hours.
INTERVENTION
Patients were retrospectively allocated into two groups and compared depending on whether they received a PPI or not.
MEASUREMENTS AND MAIN RESULTS
Seven-hundred fifty-four patients were included of which 231 received a PPI (31%). PPIs were mostly used for stress ulcer prophylaxis (174/231; 75%), but upper gastrointestinal bleed risk factors were rarely present (18%). In the unadjusted analyses, the rate of NI was 8% in the PPI exposed group versus 2% in the nonexposed group. After propensity score matching ( n = 184 per group), we failed to identify an association between PPI exposure and greater odds of NI (adjusted odds ratio 2.9 [95% CI, 0.9-9.3]; p = 0.082). However, these data have not excluded the possibility that there is up to nine-fold greater odds of NI.
CONCLUSIONS
This study highlights the prevalent use of PPIs in the PICU, and the potential association between PPIs and nine-fold greater odds of NI is not excluded.
Collapse