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 17 January 2018

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News

PPI use increases the risk of bacterial gastroenteritis

The latest issue of Clinical Gastroenterology and Hepatology evaluates the use of acid-suppressing drugs and the risk of bacterial gastroenteritis.

News image

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Gastric acid is a defense mechanism against gastrointestinal infections caused by ingested bacteria.

Studies have suggested that the use of acid-suppressing drugs may increase the risk of gastroenteritis.

Dr Luis Alberto García Rodríguez and colleagues identified 6414 patients aged 20 to 74 years with an episode of acute bacterial gastroenteritis.

The team matched 50,000 control patients from the same study population without a diagnosis of gastroenteritis by age, sex, and calendar year to the case group.

Clostridium gastroenteritis cases were rare
Clinical Gastroenterology and Hepatology

The team used unconditional logistic regression to calculate the adjusted relative risk of gastroenteritis in patients using proton pump inhibitors or histamine-2 receptor antagonists.

The researchers note an association with current use of proton pump inhibitors (PPIs) and an increased risk of bacterial gastroenteritis compared with nonuse.

No association was observed with histamine-2 receptor antagonists use.

The researchers found doubling the proton pump inhibitor dose further increased the risk of developing bacterial gastroenteritis.

The effect of proton pump inhibitor use did not vary significantly with regard to treatment indication.

The team observed that the increased risk associated with proton pump inhibitor use was similar for both omeprazole, and lansoprazole.

However, neither cimetidine nor ranitidine showed any increased risk.

The team found Campylobacter in 4124 patients, and Salmonella in 1885 patients were the 2 species most frequently responsible for gastroenteritis episodes in the case group.

When analyzed separately, both species reproduced the increased risk associated with proton pump inhibitor use and not histamine-2 receptor antagonists use.

Clostridium gastroenteritis cases were rare.

Dr Rodriguez's team concluded, "This study suggests that gastric acid suppression induced by proton pump inhibitors but not histamine-2 receptor antagonists is associated with an increased risk of Campylobacter and Salmonella gastroenteritis."

Clin Gastroenterol Hepatol 2007: 5(12): 1418-23
12 December 2007

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