Monika Sarkar, MD; Sean Hennessy, PharmD, PhD; Yu-Xiao Yang, MD, MSCE
Grant Support: By an Academic Development Fund by the Department of Medicine, University of Pennsylvania (Dr. Yang).
Potential Financial Conflicts of Interest:Consultancies: S. Hennessy (Wyeth), Y.X. Yang (AstraZeneca). Grants received: Y.X. Yang (AstraZeneca, GlaxoSmithKline).
Reproducible Research Statement:Study protocol: Available from Dr. Yang (e-mail, firstname.lastname@example.org). Statistical code and data set: Not available.
Requests for Single Reprints: Yu-Xiao Yang, MD, MSCE, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, 722 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021; e-mail, email@example.com.
Current Author Addresses: Dr. Sarkar: Hospital of the University of Pennsylvania, 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104.
Dr. Hennessy: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, 803 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021.
Dr. Yang: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, 722 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021.
Author Contributions: Conception and design: M. Sarkar, S. Hennessy, Y.-X. Yang.
Analysis and interpretation of the data: M. Sarkar, S. Hennessy, Y.-X. Yang.
Drafting of the article: M. Sarkar, Y.-X. Yang.
Critical revision of the article for important intellectual content: M. Sarkar, S. Hennessy, Y.-X. Yang.
Final approval of the article: M. Sarkar, S. Hennessy, Y.-X. Yang.
Provision of study materials or patients: Y.-X. Yang.
Statistical expertise: Y.-X. Yang.
Obtaining of funding: Y.-X. Yang.
Administrative, technical, or logistic support: Y.-X. Yang.
Collection and assembly of data: Y.-X. Yang.
Sarkar M, Hennessy S, Yang Y. Proton-Pump Inhibitor Use and the Risk for Community-Acquired Pneumonia. Ann Intern Med. 2008;149:391-398. doi: 10.7326/0003-4819-149-6-200809160-00005
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Published: Ann Intern Med. 2008;149(6):391-398.
Proton-pump inhibitors (PPIs) are potent gastric acid suppressants. With its excellent efficacy for acid-related diseases and increasing availability of both over-the-counter and generic formulations, PPI use continues to escalate (1). Antiulcer drugs, primarily PPIs, ranked second in overall U.S. retail sales at $10.8 billion in 2001 (2).
Two studies recently suggested that PPI use may increase the risk for community-acquired pneumonia (CAP) (3, 4). A proposed mechanism is increased bacterial colonization in the upper gastrointestinal tract due to gastric acid suppression (3, 4). However, other noncausal mechanisms may also be responsible for the association between PPIs and CAP. Residual confounding may have contributed to the relatively modest increased risk seen in these studies. Furthermore, both studies found that the association was weakest among current recipients who had been taking PPIs for the longest duration, which is contrary to what one would expect if PPIs increase the risk for CAP.
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Infectious Disease, Pulmonary/Critical Care, Pneumonia.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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