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Gastro Hep Adv.2025 Oct 08;5(2):100832.doi:10.1016/j.gastha.2025.100832
Abstract
BACKGROUND AND AIMS: Adverse outcomes associated with the treatment of remain poorly understood. We investigated whether treatment was associated with an increased risk of infection (CDI).
METHODS: This retrospective cohort study included all adult members who tested positive for between January 1, 2000, and December 31, 2020, at Kaiser Permanente Northern California. We measured the incidence of CDI after treatment and evaluated the predictors of CDI using multivariable logistic regression.
RESULTS: Of 139,226 individuals who tested positive for , the incidence of CDI was 5.9/10,000 within 3 months ( = .02) and 7.0/10,000 ( = .003) within 6 months after treatment, compared with 2.7/10,000 among untreated individuals. The adjusted odds ratio (aOR) (95% confidence interval) for CDI within 3 months after treatment was 2.00 (1.02-3.90) overall, 3.15 (1.14-8.70) for concomitant therapy, and 6.34 (2.75-14.59) for bismuth quadruple therapy. Inflammatory bowel disease (IBD) (aOR, 7.89 [2.38-26.21]) and history of CDI (aOR, 8.27 [1.92-35.62]) had the strongest association with CDI, while Asians/Pacific Islanders (aOR, 0.22 [0.09-0.55] and non-English language preference (aOR, 0.30 [0.12-0.72]) were associated with a lower risk.
CONCLUSION: In a large, diverse, community-based population, treatment of was associated with an increased risk of CDI, although the overall incidence was very low. History of IBD and prior CDI were the strongest predictors of CDI. These findings support the safety of treatment, although caution should be exercised when treating among individuals with IBD or a prior history of CDI.
