Use of PPIs Modestly Associated with Veterans’ Pneumonia

Has the use of proton pump inhibitors (PPI) increased the risk of community-acquired pneumonia (CAP) in veterans? Research suggests a modest association.

“Among the veterans studied, current compared with past PPI exposures associated modestly with increased risks of CAP. However, our observations that recent treatment initiation and higher PPI doses were associated with greater risks, and the inconsistent PPI-CAP associations between patient subgroups, indicate that further inquiries are needed to separate out coincidental patterns of associations,” wrote the authors of a recent study of patients at the New England VA Healthcare System in Bedford, MA. 1

The retrospective, nested case-control study was done by a team of researchers from the VA Boston Healthcare System, Boston University and Harvard Medical School.

Using linked pharmacy and administrative databases of the New England VA system, researchers identified 71,985 outpatients who had been newly prescribed PPIs between 1998 and 2007. They then calculated crude and adjusted odds ratios comparing current with past PPI exposures for the entire and stratified samples.

The results showed a modest association between current PPI use and CAP (adjusted odds ratio 1.29, with a 95% confidence interval,, 1.15–1.45). While risks did not significantly change based on age or year of diagnosis, dementia and sedative/tranquilizer use appeared to increase the association, although some chronic medical conditions seemed to reverse PPI-associated CAP risks. Other factors increasing the risk were — PPI exposures between one and 15 days as compared with longer exposures and taking more than one dose a day.

The authors called for more studies to determine how strong the association actually might be.

1. Hermos JA, Young MM, Fonda JR, Gagnon DR, Fiore LD, Lawler EV. Risk of
community-acquired pneumonia in veteran patients to whom proton pump inhibitors were dispensed.
Clin Infect Dis. 2012 Jan 1;54(1):33-42. Epub 2011 Nov 18. PubMed PMID: 22100573.

Back to June Articles