Proton-Pump Inhibitors Increase Serious Infection Rates in Decompensated Cirrhosis

Acid-suppressive therapy predisposes users to bacterial overgrowth and bacterial translocation. A previous study suggests that proton-pump inhibitor (PPI) use is associated with serious infections in cirrhotic patients (JW Gastroenterol Apr 20 2012) but was limited in size and did not investigate other acid-suppressive agents.

In a retrospective, propensity-matched cohort study, investigators examined U.S. Veterans Health Administration data to compare rates of serious infection associated with use of PPIs, H2 receptor antagonists (H2RAs), or no gastric acid suppressant in patients who began use after development of decompensated cirrhosis. Serious infections were defined as any infection requiring hospitalization, and a subset of these infe…