Starting PPIs is associated with an increased risk for community-acquired pneumonia (CAP), Danish researchers report in the Archives of Internal Medicine.
In a case-control study, over 7600 patients with first-admission cases of CAP were compared with roughly four times as many matched controls.
Current use of PPIs was only moderately associated with CAP (odds ratio, 1.5), and there was no association with past use of the drugs. However, there was a strong association (OR, 5.0) with having started PPIs within a week of the diagnosis.
The authors warn that their study is limited by the use of only hospitalized patients and acknowledge that PPI users are more likely to have chronic diseases — "the same patients [who] have a high risk of CAP." They speculate that PPIs might disrupt an "acid wall" that normally blocks pathogens and conclude that "PPIs should not be prescribed too casually."
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