Proton Pump Inhibitors Should be Used with Caution in Critically Ill Patients to Prevent the Risk of Clostridium difficile Infection

The incidence and severity of Clostridium difficile infection (CDI), which is the most important cause of nosocomial diarrhea, have increased globally.1–4 In North America and Europe, CDI has been well established for decades, becoming a particular issue after 2000.1 A recent nationwide study conducted in South Korea involving 17 hospitals indicated that the incidence of CDI is significantly increasing, from 1.7 cases/1,000 adult admissions in 2004 to 2.7 cases/1,000 adult admissions in 2008 (p=0.028).2 In addition, the recurrence of CDI after successful treatment is observed in approximately 20% of patients.5 Therefore, even in Asia, the emergence and considerable burden associated with CDI should not be underestimated.