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About 50% of inpatients receive acid-suppressive medications, usually proton-pump inhibitors (PPIs), although most do not have clear indications for such therapy. Risk for adverse consequences associated with PPI therapy is unclear, but recent studies have suggested excess risk for community-acquired pneumonia in outpatients who receive PPIs.
In a prospective case-control study from Boston, 63,878 adult inpatients (excluding intensive-care patients) who were hospitalized for at least 3 days were assessed; more than 27,000 received PPIs, and about 7500 received histamine (H2)-blockers. The incidence of hospital-acquired pneumonia was 4.9% in patients who received acid suppression versus 2.0% in those who did not. After adjustment for age, sex…