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Acid-Suppressing Meds May Boost Pneumonia Risks
Date:5/26/2009

on drugs and over-the-counter medicines.

Herzig and her colleagues reviewed data from hospital admissions from 2004 to 2007. All patients included in the study were hospitalized for at least three days, and none were in intensive care units.

Just over half -- 52 percent -- received some sort of acid-suppressing medication to help prevent stress ulcers while they were hospitalized.

After adjusting the data to account for numerous factors -- including the severity and type of illness, whether the hospitalization was for an elective procedure or an urgent condition, and more -- the researchers found that the risk of developing pneumonia in the hospital was 30 percent higher for those on acid blockers.

In a small sub-analysis, the researchers tried to assess the effect of PPIs vs. H2 blockers. Although the analysis suggested that H2 blockers did not increase the risk significantly, Herzig said there were not enough people in the study on both medications for the researchers to reach a definitive, statistically significant conclusion.

She said that several theories might explain how the medications seem to increase the risk of pneumonia.

  • By suppressing acid, more bacteria might be able to flourish and travel to the lungs.
  • Acid might stimulate the cough response, which is one of the body's ways of clearing infectious agents.
  • Acid-suppressive medications might depress immune function.

"I think we have to address whether acid-suppressors should be used in every patient," Cappell said. "They cost money, they have side effects and they're being used all the time for very weak reasons."

However, he said, it's important for people to realize that even though the risk of hospital-acquired pneumonia was increased with acid-suppressors, the overall risk remains low. He said the study's findings also need to be confirmed with additional research.

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