Mixed Evidence on the Link Between PPIs and Infection Risk

A systematic review suggests that chronic PPI use increases the risk for enteric infection with Clostridium difficile, Salmonella, and Campylobacter jejuni.

Given that gastric acid protects the upper gastrointestinal (GI) tract from ingested pathogens, concerns have been raised that the use of acid suppressants, such as proton-pump inhibitors (PPIs), might contribute to enteric infection. Additional data also suggest that PPIs might increase infection risk through a direct, negative effect on white blood cell function. In this systematic review, researchers examined the relationship between PPI use and susceptibility to seven specific enteric infections.

The evidence indicated that PPI use increases the risk for infection with Clostridium difficile, Salmonella spp., and Campylobacter jejuni. For C. difficile, 17 of the 27 available studies suggested a positive association, with relative risks ra…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors