Proton Pump Inhibitor Use and Associated Infectious Complications in the PICU: Propensity Score Matching Analysis.

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.
Competing Interests: Dr. Goyer received funding from Braun Medical. Dr. Dupont received funding from Abbvie. The remaining authors have disclosed that they do not have any potential conflicts of interest.
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