| Association between proton pump inhibitors and spontaneous bacterial peritonitis in cirrhotic patients - a systematic review and meta-analysis. | |
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MedLine Citation:
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PMID: 21564440 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Acid suppressive therapy, in the form of proton pump inhibitor (PPI), is widely used in cirrhotic patients, often in indications which are not clearly justified. PPI facilitates enteric bacterial colonisation, overgrowth and translocation, which might predispose to spontaneous bacterial peritonitis. However, observational studies evaluating the association of PPI and SBP in cirrhotic patients have yielded inconsistent results. We therefore conducted a meta-analysis of relevant clinical studies to determine the nature of this association. Observational studies assessing the association between SBP and PPI in cirrhosis, conducted in adult population and published in all languages, were identified through systematic search in the MEDLINE, EMBASE and manual reviews of all major gastroenterology meeting proceedings up to May 2010. The relevant studies were pooled using traditional meta-analytic techniques with a random-effects model. Four studies were identified and included in the meta-analysis. The pooled analysis, involving a total of 772 patients, found a significant association between the use of PPI and the development of SBP (OR 2.77, 95% CI 1.82-4.23). There was very little degree of heterogeneity as reflected by an I(2) value of 22% and the visual inspection of the funnel plot. There is a potential association between use of PPI and development of SBP. Therefore, PPIs should be used judiciously and only when clearly indicated in cirrhotics. Further studies are essential to clarify this relationship and elucidate the underlying mechanisms. |
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Authors:
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G Trikudanathan; J Israel; J Cappa; D M O'Sullivan |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: International journal of clinical practice Volume: 65 ISSN: 1742-1241 ISO Abbreviation: Int. J. Clin. Pract. Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-05-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9712381 Medline TA: Int J Clin Pract Country: England |
Other Details:
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Languages: eng Pagination: 674-8 Citation Subset: IM |
Copyright Information:
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© 2011 Blackwell Publishing Ltd. |
Affiliation:
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Department of Internal Medicine, University of Connecticut Medical Center, Farmington, CT, USA Division of Gastroenterology, Hartford Hospital, Hartford, CT, USA Department of Research Administration, Hartford Hospital, Hartford, CT, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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