Updated meta-analysis of controlled observational studies: proton-pump inhibitors and risk of Clostridium difficile infection F. Cao, C.X. Chen, M. Wang,

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Updated meta-analysis of controlled observational studies: proton-pump inhibitors and risk of Clostridium difficile infection F. Cao, C.X. Chen, M. Wang, H.R. Liao, M.X. Wang, S.Z. Hua, B. Huang, Y. Xiong, J.Y. Zhang, Y.L. Xu Journal of Hospital Infection Volume 98, Issue 1, Pages 4-13 (January 2018) DOI: 10.1016/j.jhin.2017.08.017 Copyright © 2017 The Healthcare Infection Society Terms and Conditions

Figure 1 Study selection process. PPI, proton-pump inhibitor; CDI, Clostridium difficile infection. Journal of Hospital Infection 2018 98, 4-13DOI: (10.1016/j.jhin.2017.08.017) Copyright © 2017 The Healthcare Infection Society Terms and Conditions

Figure 2 Risk of incident Clostridium difficile infection with proton-pump inhibitor use. ES, effect size; CI, confidence interval. Journal of Hospital Infection 2018 98, 4-13DOI: (10.1016/j.jhin.2017.08.017) Copyright © 2017 The Healthcare Infection Society Terms and Conditions

Figure 3 Risk of hospital-acquired Clostridium difficile infection (CDI) and community-associated CDI with proton-pump inhibitor use. ES, effect size; CI, confidence interval. Journal of Hospital Infection 2018 98, 4-13DOI: (10.1016/j.jhin.2017.08.017) Copyright © 2017 The Healthcare Infection Society Terms and Conditions

Figure 4 Risk of hospital-acquired Clostridium difficile infection in intensive care unit and general ward with proton-pump inhibitor use. ES, effect size; CI, confidence interval. Journal of Hospital Infection 2018 98, 4-13DOI: (10.1016/j.jhin.2017.08.017) Copyright © 2017 The Healthcare Infection Society Terms and Conditions

Figure 5 Risk of developing Clostridium difficile infection in cohort studies and case–control studies with proton-pump inhibitor. Journal of Hospital Infection 2018 98, 4-13DOI: (10.1016/j.jhin.2017.08.017) Copyright © 2017 The Healthcare Infection Society Terms and Conditions

Figure 6 Begg funnel plot proton-pump inhibitor (PPI) and the risk for Clostridium difficile infection. OR, odds ratio; SE, standard error. Journal of Hospital Infection 2018 98, 4-13DOI: (10.1016/j.jhin.2017.08.017) Copyright © 2017 The Healthcare Infection Society Terms and Conditions

Figure 7 Cumulative meta-analysis of risk of developing Clostridium difficile infection with proton-pump inhibitor. Journal of Hospital Infection 2018 98, 4-13DOI: (10.1016/j.jhin.2017.08.017) Copyright © 2017 The Healthcare Infection Society Terms and Conditions