PPIs and H₂-Blockers: Not So Benign

In the inpatient setting, acid-suppressing agents (proton-pump inhibitors [PPIs] and histamine-2 [H₂]-blockers) are prescribed prophylactically for very high–risk patients to prevent stress ulcer–related gastrointestinal bleeding and, in many instances, are overprescribed compared with guideline recommendations (JW Gastroenterol Jun 13 2006). This practice might be problematic, because studies have suggested excess risk for pneumonia in patients who receive acid-suppressing agents (JW Gen Med Jun 11 2009).

To estimate risk for pneumonia in patients who received acid-suppressing agents, investigators summarized data from 8 observational studies and 23 randomized controlled trials (RCTs). The observational data suggested that both PPIs and H₂-…