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Heartburn Drugs May Raise Pneumonia Risk
Date:12/20/2010

hat found that taking PPIs increased the chances of developing pneumonia by 27 percent, while taking H2 blockers resulted in a 22 percent increased chance of pneumonia.

An analysis of 23 randomized clinical trials found people taking H2 blockers had a 22 percent increased chance of getting hospital-acquired pneumonia.

"Gastroenterologists in general have become more cognizant of the fact that these drugs can have some side effects," said Dr. Michael Brown, a gastroenterologist at Rush University Medical Center in Chicago. "For a long time, we were very happy to suppress people's acid without thinking about the consequences. Now we are starting to see some issues."

Hospital patients are often given acid-suppressing drugs, with studies showing them prescribed to as many as 40 to 70 percent of hospitalized patients. The authors suggest these drugs may be a cause of hospital-acquired pneumonia.

The rationale is that patients in intensive care units have decreased blood flow to the stomach, which can lead to ulcers and bleeding, a life-threatening condition that PPIs can prevent, Brown said.

The problem is that many patients prescribed the drugs in the hospital also go home with a prescription and continue taking PPIs, perhaps unnecessarily, Brown said.

According to the study, one in every 200 inpatients treated with acid-suppressing medications will develop pneumonia. The increased risk isn't huge, but it's still meaningful, Brown said.

"These drugs are given out like candy. You are talking about very large numbers of people taking the drugs," Brown said. "The study found a moderate increase in pneumonia, but, given the very large numbers of people who use these drugs, it's very significant."

The most plausible reason why suppressing acid in the stomach might raise the risk of pneumonia, Brown said, is that stomach acid acts as a barrier helping to control harmful bacteria and pathogens.

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