The aim of a systematic review by scientists in the United Kingdom was to assess the incidence of pseudomembranous colitis (MVP) and its exacerbations in patients taking proton pump inhibitors (PPIs), as well as d '' assess the effect of concomitant use of antibiotics or changes in antisecretory therapy in the form of the appointment of blockers of histamine H2 receptors.

To this end, controlled observational studies have been evaluated from the MEDLINE and EMBASE databases to assess the risk of developing MVP during the appointment of PPIs since the creation of the database until December 2011.

The review included 42 observational studies combining data from 313,000 patients. A total analysis of 39 studies revealed statistically significant relationships between the use of PPI and the development of MVP, the risk ratio (RR) of 1.74 (95% confidence interval (CI) of 1.47 -2.85, p is less than 0.001), compared to patients taking PPI. A total analysis of 3 studies showed a significant concomitant risk of recurrent MVP with PPI intake (RR 2.51, 95% CI 1.16-5.44, p less than 0.005). The analysis by subgroups did not meet expectations given the absolute clarity of the cause of significant statistical heterogeneity. Corrected indirect comparison showed that using histamine H2 receptor blockers as an alternative therapy is associated with a lower risk of MVP compared to PPI (RR 0.71, 95% CI 0.53 -0.97). The co-administration of PPI and antibiotics, on the other hand, was accompanied by an increased risk of VPM (RR 1.96, 95% CI 1.037-3.70) compared to monotherapy with PPI.. For PPIs and antibiotics, the Rothman synergy index was 1.36 and the correlated risk ratio for drug interactions was 0.19, which confirmed the increased risk of MVP during combination therapy compared to prescription of medications separately.

Thus, despite significant statistical and clinical heterogeneity, the results of the meta-analysis showed a possible relationship between the appointment of proton pump inhibitors and the incidence of primary episodes and relapses of MVP. In addition, the risk of developing this complication increases with the simultaneous administration of PPIs and antibiotics. At the same time, the use of H2 blockers of histamine receptors is safer in this regard.