{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T07:03:25Z","timestamp":1775027005147,"version":"3.50.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2020,8,13]],"date-time":"2020-08-13T00:00:00Z","timestamp":1597276800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute on Aging San Antonio Claude D.\u00a0Pepper Older Americans Independence Center","award":["1P30AG044271-01A1"],"award-info":[{"award-number":["1P30AG044271-01A1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Clostridioides difficile infection (CDI) is primarily mediated by alterations in the host gut ecosystem. While antibiotic use is the primary risk factor for CDI, other medications that modulate the gut ecosystem, particularly those targeting the gut\u2013brain axis, could impact CDI risk. This study aimed to investigate the association between recent antidepressant and gamma-aminobutyric acid (GABA)\u2013ergic medication use with CDI risk in a national cohort of United States veterans.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a retrospective case\u2013control study of patients seen in Veterans Health Administration facilities from October 2002 to September 2014. CDI and non-CDI control patients were propensity score matched 1:1 using a maximum caliper of 0.0001. Antidepressant and GABAergic medication use 90 days before cohort inclusion were analyzed for CDI association using bivariable and multivariable logistic regression models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 85 831 patients were included, and 9287 CDI and 9287 control patients were propensity score matched. Antidepressant use overall was not significantly associated with CDI risk (odds ratio [OR], 1.05; 95% CI, 0.98\u20131.12), although GABAergic medication use was associated with increased risk (OR, 1.81; 95% CI, 1.70\u20131.92). In multivariable models of individual medications\/classes, benzodiazepines had the strongest CDI association (OR, 1.91; 95% CI, 1.77\u20132.07). SSRIs (OR, 0.88; 95% CI, 0.81\u20130.95) and bupropion (OR, 0.67; 95% CI, 0.57\u20130.78) were negatively associated with CDI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this national study of veterans, GABAergic medication use was a positive predictor of CDI risk, though antidepressant use was not. Further research is needed to understand biological mechanisms, and confirmatory studies are needed to validate these findings.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaa353","type":"journal-article","created":{"date-parts":[[2020,8,14]],"date-time":"2020-08-14T05:20:29Z","timestamp":1597382429000},"source":"Crossref","is-referenced-by-count":7,"title":["GABAergic but not Antidepressant Medications Increase Risk for Clostridioides difficile Infection in a National Cohort of Veterans"],"prefix":"10.1093","volume":"7","author":[{"given":"Falak","family":"Lalani","sequence":"first","affiliation":[{"name":"College of Pharmacy, The University of Texas at Austin, Austin, Texas, USA"},{"name":"Pharmacotherapy Education & Research Center, UT Health San Antonio, San Antonio, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric H","family":"Young","sequence":"additional","affiliation":[{"name":"College of Pharmacy, The University of Texas at Austin, Austin, Texas, USA"},{"name":"Pharmacotherapy Education & Research Center, UT Health San Antonio, San Antonio, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rupesh M","family":"Panchal","sequence":"additional","affiliation":[{"name":"College of Pharmacy, The University of Texas at Austin, Austin, Texas, USA"},{"name":"Pharmacotherapy Education & Research Center, UT Health San Antonio, San Antonio, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly R","family":"Reveles","sequence":"additional","affiliation":[{"name":"College of Pharmacy, The University of Texas at Austin, Austin, Texas, USA"},{"name":"Pharmacotherapy Education & Research Center, UT Health San Antonio, San Antonio, Texas, USA"},{"name":"South Texas Veterans Health Care System, San Antonio, Texas, 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