Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-13T01:18:26.143Z Has data issue: false hasContentIssue false
  • English
  • Français

Guideline implementation is effective at reducing proton pump inhibitor use in hematology-oncology units: A multidisciplinary intervention for reducing Clostridioides difficile risk

Published online by Cambridge University Press:  30 August 2019

Matthew J. Ziegler Open the ORCID record for Matthew J. Ziegler [Opens in a new window] ,
Craig Freyer ,
Daniel Landsburg ,
David Pegues ,
Warren Bilker ,
Rebecca Hirsh ,
Colleen Kucharczuk ,
Cheryl Gilmar ,
Theresa Gorman  and
Melissa Palmer
...Show all authors
Matthew J. Ziegler*
Affiliation:
Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Craig Freyer
Affiliation:
Department of Pharmacy Services, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
Daniel Landsburg
Affiliation:
Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
David Pegues
Affiliation:
Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania Department of Healthcare Epidemiology, Infection Prevention and Control, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
Warren Bilker
Affiliation:
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
Rebecca Hirsh
Affiliation:
Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Colleen Kucharczuk
Affiliation:
Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Cheryl Gilmar
Affiliation:
Department of Healthcare Epidemiology, Infection Prevention and Control, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
Theresa Gorman
Affiliation:
Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Melissa Palmer
Affiliation:
Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Christina Harker
Affiliation:
Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Erin Lightheart
Affiliation:
Center for Clinical Effectiveness and Quality Improvement, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
Jennifer H. Han
Affiliation:
Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania Department of Healthcare Epidemiology, Infection Prevention and Control, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
*
Author for correspondence: Matthew J. Ziegler, E-mail: matthew.ziegler@uphs.upenn.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

We implemented a guideline for appropriate acid suppressant use in hematology-oncology patients. This intervention resulted in a sustained reduction in proton pump inhibitor (PPI) use without an increase in rates of gastrointestinal bleeding. Practice guidelines are effective in reducing PPI use, which is associated with risk of Clostridioides difficile infection.

Type
Concise Communication
Information
Infection Control & Hospital Epidemiology , Volume 40 , Issue 11 , November 2019 , pp. 1294 - 1296
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved. 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

PREVIOUS PRESENTATION. The interim results of this study were presented at the Society for Healthcare Epidemiology of America conference as an oral abstract presentation on April 26, 2019, in Boston, Massachusetts.

†

Present affiliation: GlaxoSmithKline, Rockville, Maryland

References

Revolinski, SL, Munoz-Price, LS. Clostridium difficile in immunocompromised hosts: a review of epidemiology, risk factors, treatment, and prevention. Clin Infect Dis 2019;68:2144–2153.CrossRefGoogle ScholarPubMed
Janarthanan, S, Ditah, I, Adler, DG, Ehrinpreis, MN. Clostridium difficile–associated diarrhea and proton pump inhibitor therapy: a meta-analysis. Am J Gastroenterol 2012;107:1001–1010.CrossRefGoogle ScholarPubMed
Dial, S, Delaney, JA, Barkun, AN, Suissa, S. Use of gastric acid-suppressive agents and the risk of community-acquired Clostridium difficile-associated disease. JAMA 2005;294:2989–2995.CrossRefGoogle ScholarPubMed
Ziegler, M, Landsburg, D, Pegues, D, et al. Clinical characteristics and outcomes of hematologic malignancy patients with positive Clostridium difficile toxin immunoassay versus polymerase chain reaction test results. Infect Control Hosp Epidemiol 2018;39:863–866.CrossRefGoogle ScholarPubMed
Wahking, RA, Steele, RL, Hanners, RE, Lockwood, SM, Davis, KW. Outcomes from a pharmacist-led proton pump inhibitor stewardship program at a single institution. Hosp Pharm 2018;53:59–67.CrossRefGoogle Scholar
Kandel, CE, Gill, S, McCready, J, Matelski, J, Powis, JE. Reducing coadministration of proton pump inhibitors and antibiotics using a computerized order entry alert and prospective audit and feedback. BMC Infect Dis 2016;16:355.CrossRefGoogle Scholar
Kwok, CS, Arthur, AK, Anibueze, CI, Singh, S, Cavallazzi, R, Loke, YK. Risk of Clostridium difficile infection with acid suppressing drugs and antibiotics: meta-analysis. Am J Gastroenterol 2012;107:1011–1019.CrossRefGoogle ScholarPubMed
MacLaren, R, Reynolds, PM, Allen, RR. Histamine-2 receptor antagonists vs proton pump inhibitors on gastrointestinal tract hemorrhage and infectious complications in the intensive care unit. JAMA Intern Med 2014;174:564–574.CrossRefGoogle ScholarPubMed
Sartori, S, Trevisani, L, Nielsen, I, Tassinari, D, Panzini, I, Abbasciano, V. Randomized trial of omeprazole or ranitidine versus placebo in the prevention of chemotherapy-induced gastroduodenal injury. J Clin Oncol 2000;18:463–467.CrossRefGoogle ScholarPubMed
Numico, G, Fusco, V, Franco, P, Roila, F. Proton pump inhibitors in cancer patients: how useful they are? A review of the most common indications for their use. Crit Rev Oncol Hematol 2017;111:144–151.CrossRefGoogle Scholar
Supplementary material: File

Ziegler et al. supplementary material

Ziegler et al. supplementary material

Download Ziegler et al. supplementary material(File)
File 29.2 KB