Use of acid-suppressive drugs and risk of pneumonia: a systematic review and meta-analysis
Open accessAbstract
BACKGROUND: Observational studies and randomized controlled trials have yielded inconsistent findings about the association between the use of acid-suppressive drugs and the risk of pneumonia. We performed a systematic review and meta-analysis to summarize this association. METHODS: We searched three electronic databases (MEDLINE [PubMed], Embase and the Cochrane Library) from inception to Aug. 28, 2009. Two evaluators independently extracted data. Because of heterogeneity, we used random-effects meta-analysis to obtain pooled estimates of effect. RESULTS: We identified 31 studies: five case-control studies, three cohort studies and 23 randomized controlled trials. A meta-analysis of the eight observational studies showed that the overall risk of pneumonia was higher among people using proton pump inhibitors (adjusted odds ratio [OR] 1.27, 95% confidence interval [CI] 1.11-1.46, I(2) 90.5%) and histamine(2) receptor antagonists (adjusted OR 1.22, 95% CI 1.09-1.36, I(2) 0.0%). In the randomized controlled trials, use of histamine(2) receptor antagonists was associated with an elevated risk of hospital-acquired pneumonia (relative risk 1.22, 95% CI 1.01-1.48, I(2) 30.6%). INTERPRETATION: Use of a proton pump inhibitor or histamine(2) receptor antagonist may be associated with an increased risk of both community- and hospital-acquired pneumonia. Given these potential adverse effects, clinicians should use caution in prescribing acid-suppressive drugs for patients at risk.
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Long-term use of PPIs exposes patients to an increased risk of developing extra-intestinal disorders.
“The use of PPIs is generally well tolerated, although their long-term use exposes patients to an increased risk of developing extra-intestinal disorders[6-8]”
From Proton pump inhibitors and dysbiosis: current knowledge and aspects to be clarified (2019) · cites this paper as [8]
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- Authors
- Eom, C.-S., Jeon, C. Y., Lim, J.-W., Cho, E.-G., Park, S. M., & Lee, K.-S.
- Affiliations
- Seoul National University (KR)
- Harvard University (US)
- Catholic University of Korea (KR)
- ORCID
- Jeon, C. Y.
- Venue
- Canadian Medical Association Journal
- Publisher
- CMA Impact Inc.
- Published
- 2010-12-20
- Volume
- 183
- Issue
- 3
- Pages
- 310-319
- ISSN
- 0820-3946 (ISSN-L)
- 1488-2329
- PMC
- PMC3042441
- OpenAlex
- W2105534233
- Cited by
- 393
- References
- 74
- Citations by year
- 2026: 8 · 2025: 4 · 2024: 14 · 2023: 12 · 2022: 23 · 2021: 30 · 2020: 26 · 2019: 26 · 2018: 28 · 2017: 40 · 2016: 39 · 2015: 41 · 2014: 36 · 2013: 24 · 2012: 30
- FWCI
- 3.03
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Canadian Medical Association Journal (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Research Foundation
- National Research Foundation of Korea
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
- Keywords
- acid-suppressive drugs, proton pump inhibitors, H2 receptor antagonists, pneumonia, nosocomial pneumonia, community-acquired pneumonia, drug safety, adverse drug reactions
- MeSH terms
- Antacids, Anti-Ulcer Agents, Cross Infection, Dose-Response Relationship, Drug, Histamine H2 Antagonists, Humans, Pneumonia, Community-Acquired Infections, Proton Pump Inhibitors
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