Gut
Beyond antibiotics: Common meds quietly raise C. diff risk
Clinical takeaway: When prescribing high‑risk antibiotics—or common non‑antibiotics like PPIs or corticosteroids—reassess indication, duration, and alternatives to reduce C. difficile infection (CDI) risk, especially in vulnerable patients.
In this nationwide Swedish population‑based case–control study (2006–2019), investigators analyzed 42,921 CDI cases matched to 355,159 controls using linked health registries to assess drug exposures in the 30 days before diagnosis. Multivariable models adjusted for comorbidity and concomitant medications.
As expected, antibiotics carried the greatest risk—lincosamides topped the list (adjusted odds ratio [aOR], 31.4; 95% confidence interval [CI], 27.9–35.3), followed by penicillin combinations (aOR, 19.8) and cephalosporins; tetracyclines showed no association.
Notably, several non‑antibiotics were also linked to CDI. Antidiarrheals showed a strong signal (aOR, 7.3), while corticosteroids (aOR, 2.4) and PPIs (aOR, 1.8) carried moderate risk. Other associations included nervous system drugs, H2 blockers, antidepressants, constipation drugs, and beta blockers. No significant risk was seen with NSAIDs.
Conversely, lipid‑modifying agents and aspirin were associated with modestly lower CDI odds (aOR, ~0.8).
Source: Boven A, et al. (2026, March 31). Gut. Commonly prescribed drugs as risk factors for Clostridioides difficile infections: a Swedish population-based case-control study