Gastric acid-suppressive therapy and community-acquired respiratory infections


Dr R. Laheij, University Medical Center St. Radboud, Department of Gastroenterology, PO Box 9101, 6500 HB Nijmegen, The Netherlands.


Background : Bacteria and viruses have been detected in the stomach of patients during acid-suppressive therapy.

Aim : To investigate whether subjects using acid-suppressive drugs more often develop community-acquired respiratory infections when compared to those who do not use acid-suppressive drugs.

Methods : 700 study subjects were recruited during a single week in December 2002. Information on the prevalence of clinical manifestations of infections and complications in the preceding month was assessed by questionnaire. Furthermore, subjects were asked to report antibiotic therapy and physician visits related to possible infection.

Results : Questionnaires were returned by 405 subjects (58%). Consumption of acid-suppressive drugs was reported by 91 individuals, of whom 79 used proton-pump inhibitors (20%) and 12 H2-receptor antagonists (3%). Overall, 101 (25%) responders reported clinical manifestations of respiratory infection in the preceding month. Subjects using acid-suppressive drugs were 2.34 times [95% confidence interval (CI) 1.4–4.1] more likely to have clinical manifestations of infection than individuals not using acid-suppressive drugs. Subjects using acid-suppressive drugs visited a physician 3.72 times more often (95% CI 2.1–6.8) for an infection and received antibiotic therapy 4.19 times more often (95% CI 2.2–8.1) in comparison to individuals not using acid-suppressive drugs.

Conclusions : Subjects using acid-suppressive drugs more often reported community-acquired respiratory infections in comparison to those who did not use acid-suppressive drugs.