Risk of Community-Acquired Pneumonia and Use of Gastric Acid–Suppressive Drugs

摘要: ContextReduction of gastric acid secretion by acid-suppressive therapy allows pathogen colonization from the upper gastrointestinal tract. The bacteria and viruses in contaminated stomach have been identified as species from the oral cavity.ObjectiveTo examine association between use drugs and occurrence community-acquired pneumonia.Design, Setting, and ParticipantsIncident drug users with at least 1 year valid database history were Integrated Primary Care Information database between January 1, 1995, December 31, 2002. Incidence rates for pneumonia were calculated unexposed exposed individuals. To reduce confounding by indication, a case-control analysis was conducted nested cohort of incident drugs. Cases all individuals with incident pneumonia during or after stopping drugs. Up to 10 controls matched each case practice, birth, sex, and index date. Conditional logistic regression used compare risk of proton pump inhibitors (PPIs) and H2-receptor antagonists.Main Outcome MeasureCommunity-acquired defined certain (proven radiography or sputum culture) probable (clinical symptoms consistent pneumonia).ResultsThe study population comprised 364 683 who developed 5551 first occurrences follow-up. incidence rates of non–acid-suppressive acid-suppressive drug 0.6 2.45 per 100 person-years, respectively. adjusted relative risk among persons currently using PPIs compared with those stopped 1.89 (95% confidence interval, 1.36-2.62). Current antagonists had 1.63-fold increased risk 1.07-2.48) those who use. For current PPI users, significant positive dose-response relationship observed. antagonist the variation dose restricted.ConclusionCurrent acid–suppressive associated with an increased pneumonia.