TY - JOUR
T1 - Use of proton pump inhibitors and the risk of community-acquired pneumonia
T2 - a population-based case-control study
AU - Gulmez, Sinem Ezgi
AU - Holm, Anette
AU - Frederiksen, Henrik
AU - Jensen, Thøger Gorm
AU - Pedersen, Court
AU - Hallas, Jesper
PY - 2007/5/14
Y1 - 2007/5/14
N2 - BACKGROUND: Recently, the use of proton pump inhibitors (PPIs) has been associated with an increased risk of pneumonia. We aimed to confirm this association and to identify the risk factors. METHODS: We conducted a population-based case-control study using data from the County of Funen, Denmark. Cases (n=7642) were defined as all patients with a first-discharge diagnosis of community-acquired pneumonia from a hospital during 2000 through 2004. We also selected 34 176 control subjects, who were frequency matched to the cases by age and sex. Data on the use of PPIs and other drugs, on microbiological samples, on x-ray examination findings, and on comorbid conditions were extracted from local registries. Confounders were controlled by logistic regression. RESULTS: The adjusted odds ratio (OR) associating current use of PPIs with community-acquired pneumonia was 1.5 (95% confidence interval [CI], 1.3-1.7). No association was found with histamine(2)-receptor antagonists (OR, 1.10; 95% CI, 0.8-1.3) or with past use of PPIs (OR, 1.2; 95% CI, 0.9-1.6). Recent initiation of treatment with PPIs (0-7 days before index date) showed a particularly strong association with community-acquired pneumonia (OR, 5.0; 95% 2.1-11.7), while the risk decreased with treatment that was started a long time ago (OR, 1.3; 95% CI, 1.2-1.4). Subgroup analyses revealed high ORs for users younger than 40 years (OR, 2.3; 95% CI, 1.3-4.0). No dose-response effect could be demonstrated. CONCLUSION: The use of PPIs, especially when recently begun, is associated with an increased risk of community-acquired pneumonia.
AB - BACKGROUND: Recently, the use of proton pump inhibitors (PPIs) has been associated with an increased risk of pneumonia. We aimed to confirm this association and to identify the risk factors. METHODS: We conducted a population-based case-control study using data from the County of Funen, Denmark. Cases (n=7642) were defined as all patients with a first-discharge diagnosis of community-acquired pneumonia from a hospital during 2000 through 2004. We also selected 34 176 control subjects, who were frequency matched to the cases by age and sex. Data on the use of PPIs and other drugs, on microbiological samples, on x-ray examination findings, and on comorbid conditions were extracted from local registries. Confounders were controlled by logistic regression. RESULTS: The adjusted odds ratio (OR) associating current use of PPIs with community-acquired pneumonia was 1.5 (95% confidence interval [CI], 1.3-1.7). No association was found with histamine(2)-receptor antagonists (OR, 1.10; 95% CI, 0.8-1.3) or with past use of PPIs (OR, 1.2; 95% CI, 0.9-1.6). Recent initiation of treatment with PPIs (0-7 days before index date) showed a particularly strong association with community-acquired pneumonia (OR, 5.0; 95% 2.1-11.7), while the risk decreased with treatment that was started a long time ago (OR, 1.3; 95% CI, 1.2-1.4). Subgroup analyses revealed high ORs for users younger than 40 years (OR, 2.3; 95% CI, 1.3-4.0). No dose-response effect could be demonstrated. CONCLUSION: The use of PPIs, especially when recently begun, is associated with an increased risk of community-acquired pneumonia.
KW - Adult
KW - Anti-Ulcer Agents
KW - Case-Control Studies
KW - Community-Acquired Infections
KW - Dose-Response Relationship, Drug
KW - Drug Administration Schedule
KW - Female
KW - H(+)-K(+)-Exchanging ATPase
KW - Humans
KW - Male
KW - Middle Aged
KW - Pneumonia
KW - Registries
KW - Risk Factors
U2 - 10.1001/archinte.167.9.950
DO - 10.1001/archinte.167.9.950
M3 - Journal article
C2 - 17502537
SN - 0003-9926
VL - 167
SP - 950
EP - 955
JO - Archives of Internal Medicine
JF - Archives of Internal Medicine
IS - 9
ER -