Are PPIs Associated with Increased Risk of Gastrointestinal Infections?

A new study found that acid suppression medications were associated with increased the rates of gastroenteritis in patients.

Researchers used the record-linkage database in Tayside, Scotland to conduct a population-based, propensity-score matched cohort study between 1999 and 2013. There were 188,323 participants taking proton pump inhibitors (PPIs) and H2 receptor antagonists, and 376,646 participants who were not taking acid suppression medications. Stool samples were tested for C. difficile, Campylobacter, Salmonella, Shigella, or Escherichia coli O157.
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Their results showed that 22,705 participants tested positive for bacterial gastroenteritis. Toxin positive results for C. difficile were in 15,273 patients, 6590 patients had Campylobacter, 852 patients had Salmonella, 129 had Shigella, and 193 had Escherichia coli O157. Culture positive diarrhea for PPIs and H2 receptor antagonists hazard ratios were 2.72 for samples submitted by the community, and 1.28 for samples submitted by hospitals.

Overall, patients taking acid suppression medications had an increased risk for C. difficile and Campylobacter, suggesting that the medications was associated with bacterial gastroenteritis.

—Melissa Weiss

Reference:

Wei L, Ratnayake L, Philips G et al. Acid suppression medications and bacterial gastroenteritis: a population-based cohort study [published online January 5, 2017]. British Journal of Clinical Pharmacology.doi:10.1111/bcp.13205.