Acid Blockers Linked to Pneumonia Risk
Study Shows Hospital Patients Who Take Acid-Reducing Drugs May Be at Risk for Pneumonia
Hospital Patients and PPIs continued...
Some 40 million patients are discharged from the hospital in the U.S. each year, and roughly one in five patients who develop hospital-acquired pneumonia die as a result.
Assuming that 50% of hospitalized patients are prescribed acid-suppressing drugs, Herzig and colleagues estimate that 180,000 cases of hospital-acquired pneumonia and 33,000 deaths each year may be due to their use.
The researchers conclude that the routine use of acid-suppressing drugs in non-ventilated, non ICU-treated patients with a low risk for developing stress ulcers should be re-examined.
Acid-Reducing Drugs and Pneumonia
There are several theories about how acid-reducing drugs might make patients more vulnerable to pneumonia.
By reducing the acid load in the stomach, the drugs may promote the growth of different bacteria in the upper gastrointestinal and upper respiratory tract linked to pneumonia.
Or they may promote pneumonia by suppressing coughing, Herzig explains. Coughing is a frequent symptom of acid reflux and it also helps clear the lungs, which reduces pneumonia risk.
Pulmonary and critical care specialist J. Randall Curtis, MD, tells WebMD that the finding are compelling but the study does not prove a link between use of proton pump inhibitors and other acid-reducing drugs and pneumonia.
Curtis is president of the American Thoracic Society and a professor in the division of pulmonary and critical care medicine at the University of Washington. "While I would argue that the study is not conclusive, I would also say that it is a wake-up call to hospital-based physicians to really look at situations in which these medications are prescribed and ask themselves if they are, in fact, indicated."
Herzig adds that the pneumonia risk to hospitalized and non-hospitalized people who have clear indications for taking acid-suppressing drugs is minimal.
"Patients who are taking these medications for symptoms such as frequent heartburn or ulcers should not stop taking them," she says. "The risk to these patients is very small."