HOME
Return to Table of Contents
138 PROTON PUMP INHIBITOR USE IS ASSOCIATED WITH AN INCREASED RISK OF SEVERE COMMUNITY-ACQUIRED INFECTIONS LE Targownik, RJ Laheij, CM Metge, S Leung BACKGROUND: Proton pump inhibitor (PPI) use has been associated with an increased risk of community acquired pneumonia and C. difficile, presumably secondary to loss of the natural antibacterial host defenses provided by gastric acid. The relationship between PPI use and other serious infections remains uncharacterized.
Department of Internal Medicine and Pharmacy, University of Manitoba, Winnipeg, Manitoba; Department of Medicine, St Radboud Medical Centre, Nijmegen, Netherlands
OBJECTIVE: To determine whether the use of PPIs increases the risk of severe community-acquired infections in a large population-based health utilization dataset.
METHODS: We conducted a population-based case-control study using a comprehensive health utilization database from Manitoba, Canada. We identified all individuals admitted to hospital with severe community-acquired infections in subjects with either ongoing or previous use of PPIs between October 1995 and March 2004. Up to 10 controls were matched on sex, year of birth, and index date. Conditional logistic regression was used to estimate the relationship between active use of PPIs and serious community acquired infections.
RESULTS: We identified 119,047 PPI users of whom 904 met our diagnostic criteria for severe community acquired infections. Patients with severe infections were more likely than controls to be actively using PPIs (adjusted OR 1.55, 95% CI 1.31-1.84). The association was increased for high dose PPI users, (adjusted OR 1.89, 95% CI: 1.41-2.54). Both respiratory and non-respiratory severe infections were associated with active PPI use. Mortality was also increased among PPI users (OR 1.60 (95% CI: 1.21-2.10).
CONCLUSION: The use of proton pump inhibitors is associated with an increased risk of severe community-acquired infections. Further research is required to confirm the nature of this clinically significant relation.