PWE-158 Non-selective non-steroidal antiinflammatory drugs, proton pump inhibitors, and the incidence of non-variceal upper gastrointestinal bleeding and Clostridium difficile infection

IntroductionIt is not clear what impact the decline of COX-2 selective inhibitors has had on the use of non-selective non-steroidal anti-inflammatory drugs (ns-NSAIDs) or on the incidence of non-variceal upper gastrointestinal bleeding (NV-UGIB). Also, proton pump inhibitors (PPIs), recommended for NSAID-ulcer prophylaxis, have been linked to Clostridium difficile infection.MethodsWe aimed to measure the incidence [cases per 100 000 population per annum] of NV-UGIB and C difficile infection as well as the use of ns-NSAIDs and PPIs in a well-defined population served by a single centre. Data were collected over three calendar years, 2007–2009. Significance was assessed using the χ2 test for trend.ResultsAs shown in Abstract PWE-158 table 1, the use of COX-2 selective and newer NSAIDs continues to decline, while that of ns-NSAIDs continues to rise. This has been coupled with a steady rise in the use of PPIs. On the other hand, the incidence of both NV-UGIB and C difficile infection has been falling.Abstract PWE-158 Table 1The incidence of non-variceal upper gastrointestinal bleeding and Clostridium difficile infection, and the annual number of prescriptions [per 100 000 population]200720082009p ValueTotal population255 330255 840255 720–COX-2 & Newer-NSAID use15.0×10314.5×10314.1×103