Details

Autor(en) / Beteiligte

• Eom, Chun-Sick
• Jeon, Christie Y
• Lim, Ju-Won
• Cho, Eun-Geol
• Park, Sang Min
• Lee, Kang-Sook

Titel

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

Ist Teil von

• Canadian Medical Association journal (CMAJ), 2011-02, Vol.183 (3), p.310-319

Ort / Verlag

Canada

Erscheinungsjahr

2011

Quelle

MEDLINE

Beschreibungen/Notizen

• 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. 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. 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, I(2) 90.5%) and histamine(2) receptor antagonists (adjusted OR 1.22, 95% CI 1.09-1.36, I(2) 0.0%). In the randomized controlled trials, use of histamine(2) receptor antagonists was associated with an elevated risk of hospital-acquired pneumonia (relative risk 1.22, 95% CI 1.01-1.48, I(2) 30.6%). Use of a proton pump inhibitor or histamine(2) 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.