Document Detail

Use of proton pump inhibitors and the risk of community-acquired pneumonia: a population-based case-control study.
MedLine Citation:
PMID:  17502537     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Recently, the use of proton pump inhibitors (PPIs) has been associated with an increased risk of pneumonia. We aimed to confirm this association and to identify the risk factors. METHODS: We conducted a population-based case-control study using data from the County of Funen, Denmark. Cases (n=7642) were defined as all patients with a first-discharge diagnosis of community-acquired pneumonia from a hospital during 2000 through 2004. We also selected 34 176 control subjects, who were frequency matched to the cases by age and sex. Data on the use of PPIs and other drugs, on microbiological samples, on x-ray examination findings, and on comorbid conditions were extracted from local registries. Confounders were controlled by logistic regression. RESULTS: The adjusted odds ratio (OR) associating current use of PPIs with community-acquired pneumonia was 1.5 (95% confidence interval [CI], 1.3-1.7). No association was found with histamine(2)-receptor antagonists (OR, 1.10; 95% CI, 0.8-1.3) or with past use of PPIs (OR, 1.2; 95% CI, 0.9-1.6). Recent initiation of treatment with PPIs (0-7 days before index date) showed a particularly strong association with community-acquired pneumonia (OR, 5.0; 95% 2.1-11.7), while the risk decreased with treatment that was started a long time ago (OR, 1.3; 95% CI, 1.2-1.4). Subgroup analyses revealed high ORs for users younger than 40 years (OR, 2.3; 95% CI, 1.3-4.0). No dose-response effect could be demonstrated. CONCLUSION: The use of PPIs, especially when recently begun, is associated with an increased risk of community-acquired pneumonia.
Sinem Ezgi Gulmez; Anette Holm; Henrik Frederiksen; Thøger Gorm Jensen; Court Pedersen; Jesper Hallas
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of internal medicine     Volume:  167     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-05-15     Completed Date:  2007-06-28     Revised Date:  2010-10-04    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  950-5     Citation Subset:  AIM; IM    
Research Unit of Clinical Pharmacology, Faculty of Health Sciences, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
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MeSH Terms
Anti-Ulcer Agents / administration & dosage*
Case-Control Studies
Community-Acquired Infections / epidemiology
Dose-Response Relationship, Drug
Drug Administration Schedule
H(+)-K(+)-Exchanging ATPase / antagonists & inhibitors*
Middle Aged
Pneumonia / epidemiology*,  microbiology
Risk Factors
Reg. No./Substance:
0/Anti-Ulcer Agents; EC ATPase
Comment In:
Arch Intern Med. 2008 May 26;168(10):1118-9; author reply 1119   [PMID:  18504343 ]
Arch Intern Med. 2010 Sep 27;170(17):1604-5   [PMID:  20876414 ]

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