PPIs: The Hospital Epidemiologist's New Challenge?

2 more studies (May 10 issue of the Archives of Internal Medicine- here and here) tie use of proton pump inhibitors (PPIs) to Clostridium difficile infection. These drugs have been linked to C. difficile in past reports, and have also been linked to hospital associated pneumonia. Although the risk is still generally small, these are among the top 3 most frequently prescribed classes of drugs in the US. I'm always amazed when I attend on Medicine how many people are on these drugs for unknown reasons. Some statistics reveal that 60-70% of people who take them don’t really need them. Maybe its time we expand our view of antibiotic stewardship in hospitals?