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Results of observational studies suggest an elevated risk for hospitalization for community-acquired pneumonia (CAP) in patients using proton-pump inhibitors (PPIs). The hypothesis is that the alteration of gastric pH leads to diminished bactericidal protection and, consequently, increased risk for infection. However, as the patients in those studies were often taking PPIs for gastroesophageal reflux disease (GERD), which itself is an independent risk factor for CAP, the results may have been biased toward a positive association due to uncontrolled confounding.
In the current study, investigators specifically selected patients who were prescribed PPIs for a non-GERD indication — prevention of complications associated with use of nonsteroidal…