Adverse effects of proton pump inhibitors

Lodato, Francesca; Azzaroli, Francesco; Turco, Laura; Mazzella, Natalia; Buonfiglioli, Federica; Zoli, Marco; Mazzella, Giuseppe

doi:10.1016/j.bpg.2009.11.004

Cited by 79 publications

(62 citation statements)

References 95 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In two recent reviews, there was no supporting clinical evidence to document the development of B12 defi ciency in chronic PPI users ( 100,101 ). However, recent studies have suggested that in elderly institutionalized long-term PPI users, B12 defi ciency is more likely to develop and should be considered in this cohort.…”

Section: Summary Of the Evidencementioning

confidence: 99%

Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease

Katz¹,

Gerson²,

Vela³

2013

American Journal of Gastroenterology

1,554

1,430

View full text Add to dashboard Cite

Section: Summary Of the Evidencementioning

confidence: 99%

Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease

Katz¹,

Gerson²,

Vela³

2013

American Journal of Gastroenterology

1,554

1,430

View full text Add to dashboard Cite

“…30,31 These medications are commonly prescribed, and there is emerging literature questioning the safety of PPIs. 32,33 Many studies have addressed the association between the risk of CDI and use of acid suppression medications and have found that acid suppression is a risk factor associated with the development of CDI. 4,[34][35][36][37] However, it has not been conclusively proven that acid suppression with PPI is an independent risk factor associated with the development of CDI, and potential confounders could explain the observed associations.…”

Section: Discussionmentioning

confidence: 99%

Gastric Acid Suppression and Outcomes in Clostridium difficile Infection: A Population-Based Study

Khanna

Aronson

Kammer

et al. 2012

Mayo Clinic Proceedings

View full text Add to dashboard Cite

Objective: To evaluate the association of gastric acid suppression medications, including proton pump inhibitors and histamine type 2 blockers, with outcomes in patients with Clostridium difficile infection (CDI) in a population-based cohort. Patients and Methods: To understand the association between acid suppression and outcomes in patients with CDI, we conducted a population-based study in Olmsted County, Minnesota, from January 1, 1991, through December 31, 2005. We compared demographic data and outcomes, including severe, severe-complicated, and recurrent CDI and treatment failure, in a cohort of patients with CDI who were treated with acid suppression medications with these outcomes in a cohort with CDI that was not exposed to acid-suppressing agents. Results: Of 385 patients with CDI, 36.4% were undergoing acid suppression (23.4% with proton pump inhibitors, 13.5% with histamine type 2 blockers, and 0.5% with both). On univariate analysis, patients taking acid suppression medications were significantly older (69 vs 56 years; PϽ.001) and more likely to have severe (34.2% vs 23.6%; Pϭ.03) or severecomplicated (4.4% vs 2.6% CDI; Pϭ.006) infection than patients not undergoing acid suppression. On multivariable analyses, after adjustment for age and comorbid conditions, acid suppression medication use was not associated with severe or severecomplicated CDI. In addition, no association between acid suppression and treatment failure or CDI recurrence was found. Conclusion: In this population-based study, after adjustment for age and comorbid conditions, patients with CDI who underwent acid suppression were not more likely to experience severe or severe-complicated CDI, treatment failure, or recurrent infection.

show abstract

“…Concerns that therapy with PPIs may mask signs of gastric cancer or even induce precursors of intestinal metaplasia have also been raised. However, unlike animal studies, this has not been fully substantiated in humans (17)(18)(19). Moreover, multiple recent studies have questioned the safety of concomitant use of PPI with Clopidogrel in patients with severe cardiac disease and post-PCI.…”

Section: Introductionmentioning

confidence: 91%

Patterns and Predictors of Proton Pump Inhibitor Overuse among Academic and Non-Academic Hospitalists

Eid

Boueiz²,

Paranji

et al. 2010

Intern. Med.

View full text Add to dashboard Cite

Objective In the hospital setting, several studies have reported proton pump inhibitor (PPI) overuse, a majority of which is continued after discharge. In addition to being expensive, PPIs are associated with an increased risk of infections, osteoporosis and serious drug interactions. We examined the trends and predictors of PPI guidelines non-compliance among academic and non-academic hospitalists in USA. Methods and Patients Oral PPI prescriptions initiated by 2 academic and 2 non-academic hospitalist groups were reviewed. Prescription indications were recorded when explicitly stated in the chart. Otherwise, qualified physicians reviewed the chart to make such determination. Indications were then compared to the published guidelines. Several variables were tested to determine independent predictors of initiation and post discharge continuation of guideline non-compliant prescriptions. Results Of the 400 PPI prescriptions 39% were guideline compliant. Academic hospitalists were significantly more compliant with PPI prescription guidelines (50 vs 29%). Gastrointestinal ulcer bleeding prophylaxis (GIP) for low risk patients was the most common indication for non-compliant prescriptions, while that of guideline compliant prescriptions was dyspepsia treatment. Independent predictors of the initiation of guideline non-compliant prescriptions were non-academic hospitalist group, PPI indication not documented in the chart, and GIP as part of the admission orderset. The latter was an independent predictor of those prescriptions continuation post-discharge (protective) in addition to non-academic hospitalists group. Conclusion Hospitalists overprescribe PPI to a level comparable to that of the non-hospitalist providers in the literature. Understanding the determinants of increased compliance among academic groups is instrumental to design interventions aimed at increasing PPI prescription compliance.

show abstract

Adverse effects of proton pump inhibitors

Cited by 79 publications

References 95 publications

Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease

Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease

Gastric Acid Suppression and Outcomes in Clostridium difficile Infection: A Population-Based Study

Patterns and Predictors of Proton Pump Inhibitor Overuse among Academic and Non-Academic Hospitalists

Contact Info

Product

Resources

About