PPIs alone not linked to gastrointestinal infection
By Kirsty Oswald, medwireNews Reporter
18 April 2013
Am J Gastroenterol 2013; Advance online publication

medwireNews: Researchers have shown that a previously suggested link between the use of proton pump inhibitors (PPIs) and gastrointestinal infections with Campylobacter and Salmonella is due to the characteristics of the patients and not the drugs themselves.

Sinead Brophy (Swansea University, UK) and colleagues showed that patients given a prescription for PPIs already had an increased risk for infection prior to taking the acid-suppressing medication.

The study included data on 1,913,925 patients registered at general practices in Wales. Between 1990 and 2010, 358,938 (18.7%) patients were prescribed a PPI, with 81% of prescriptions made from 2000 onwards.

Patients who were prescribed a PPI had a higher rate of Salmonella and Campylobacter infection within 12 months compared with patients not prescribed a PPI, the authors report in the American Journal of Gastroenterology.

However, patients prescribed a PPI already had a 6.9-fold greater risk for Campylobacter infection and a 3.1-fold greater risk for Salmonella infection in the 12 months prior to prescription than patients not prescribed a PPI.

And, adjusted analyses showed nonsignificant differences between the rate of infections in the groups with prior event rate ratios of 1.17 for Campylobacter and 1.0 for Salmonella infection.

The authors also observe that the risk for infection increased over time in both the PPI and the non-PPI groups. They say this may be because the accuracy of diagnosis has improved over time, with greater standardization of testing methods.

"Thus, increases in [gastrointestinal] infection after a PPI prescription are likely to be owing to a general increase in infection diagnosis rather than a result of the PPI prescription," the authors conclude.

They add that further research will be needed to explore why people prescribed a PPI are more prone to infection even before their prescription.

medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

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