Does gastric acid suppression increase the risk of community-acquired pneumonia?
Michael E. Detsky* and David N. Juurlink *Department of Medicine; Department of Medicine, University of Toronto, Divisions of General Internal Medicine, Clinical Pharmacology and the Clinical Epidemiology Unit, Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ont. Laheij RJ, Sturkenboom MC, Hassing RJ, Dieleman J, Stricker BH, Jansen JB. Risk of community-acquired pneumonia and use of gastric acid-suppressive drugs. JAMA 2004;292(16):1955-60 Background: Dyspepsia is responsible for 7% of visits to family practitioners,1 and millions of Canadians have received 1 or both of the 2 main drug classes used to inhibit gastric acid secretion, histamine H2 receptor antagonists (H2RAs) and proton-pump inhibitors (PPIs). However, since an acidic gastric milieu serves as a defence against microorganisms, speculation exists that purposefully raising gastric pH levels may promote bacterial growth and thereby increase the risk of pneumonia. Design: Researchers in the Netherlands examin
