TITLE

Use of acid-suppressive drugs and risk of pneumonia: a systematic review and meta-analysis

AUTHOR(S)
Chun-Sick Eom; Jeon, Christie Y.; Ju-Won Lim; Eun-Geol Cho; Sang Min Park; Kang-Sook Lee
PUB. DATE
February 2011
SOURCE
CMAJ: Canadian Medical Association Journal;2/22/2011, Vol. 183 Issue 3, p310
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
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, I2 90.5%) and histamine2 receptor antagonists (adjusted OR 1.22, 95% CI 1.09-1.36, I2 0.0%). In the randomized controlled trials, use of histamine2 receptor antagonists was associated with an elevated risk of hospital-acquired pneumonia (relative risk 1.22, 95% CI 1.01-1.48, I2 30.6%). Interpretation: Use of a proton pump inhibitor or histamine2 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.
ACCESSION #
58667197

 

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