Article Text

PDF

Gastroduodenal
PWE-158 Non-selective non-steroidal antiinflammatory drugs, proton pump inhibitors, and the incidence of non-variceal upper gastrointestinal bleeding and Clostridium difficile infection
  1. A S Taha1,
  2. C Kelly1,
  3. C McCloskey2,
  4. T Craigen2,
  5. W J Angerson3
  1. 1Department of Medicine, University of Glasgow, Glasgow, UK
  2. 2Department of Medicine, University Hospital, Crosshouse, Kilmarnock, UK
  3. 3Department of Surgery, University of Glasgow, Glasgow, UK

Abstract

Introduction It is not clear what impact the decline of COX-2 selective inhibitors has had on the use of non-selective non-steroidal anti-inflammatory drugs (ns-NSAIDs) or on the incidence of non-variceal upper gastrointestinal bleeding (NV-UGIB). Also, proton pump inhibitors (PPIs), recommended for NSAID-ulcer prophylaxis, have been linked to Clostridium difficile infection.

Methods We aimed to measure the incidence [cases per 100 000 population per annum] of NV-UGIB and C difficile infection as well as the use of ns-NSAIDs and PPIs in a well-defined population served by a single centre. Data were collected over three calendar years, 2007–2009. Significance was assessed using the χ2 test for trend.

Results As shown in Abstract PWE-158 table 1, the use of COX-2 selective and newer NSAIDs continues to decline, while that of ns-NSAIDs continues to rise. This has been coupled with a steady rise in the use of PPIs. On the other hand, the incidence of both NV-UGIB and C difficile infection has been falling.

Abstract PWE-158 Table 1

The incidence of non-variceal upper gastrointestinal bleeding and Clostridium difficile infection, and the annual number of prescriptions [per 100 000 population]

Conclusion The incidence of NV-UGIB has been falling despite the increasing use of ns-NSAIDs. This could be, at least in part, due to the rise in PPI use. Also, the incidence of C difficile infection has been falling despite more PPIs being used: this might suggest a poor link between these two factors, or might reflect the outcome of other measures being deployed against this infection. While these falls appear promising, both NV-UGIB and C difficile infection continue to represent significant clinical challenges.

Competing interests None declared.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.