According to background information in the article, 20 to 40 percent of the general population experiences at least one episode of indigestion or gastroesophageal reflux disease (GERD, a backflow of acid from the stomach into the swallowing tube or esophagus) and five percent consult a general practitioner for their ailment. In primary care, a common way to treat these symptoms is to reduce gastric (stomach) acid secretions with the use of acid-suppressive drugs. However, these medications can increase vulnerability to infections, as stomach acidity is a major defense mechanism against ingested pathogens.

Robert J.F. Laheij, Ph.D., from the University Medical Center St. Radboud, Nijmegen, Netherlands, and colleagues studied pneumonia rates of both patients who did and did not use acid-suppressing medication. Patients were identified from the Integrated Primary Care Information (IPCI) database between January 1995 and December 2002. The study population included 364,683 individuals from the Netherlands who developed 5,551 cases of pneumonia for the first time.

The researchers found that current use of all acid-suppressive drugs was associated with a 27 percent increase in the risk of pneumonia, with higher risks for specific classes of acid-suppressive drugs (such as proton pump inhibitors or H2-receptor antagonist drugs).

"The effectiveness of acid-suppressive drugs in the treatment of upper gastrointestinal tract symptoms is excellent. Acid-suppressive drugs nevertheless seem to have some significant drawbacks," write the authors. "Persons using acid-suppressive drugs more often develop a community-acquired pneumonia compared with those who do not use acid-suppressive drugs, which is in general not a problem because the risk for developing
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Contact: Robert J.F. Laheij, Ph.D.
r.laheij@mdl.umcn.nl
JAMA and Archives Journals
26-Oct-2004