Proton-Pump Inhibitor Use and Mortality Risk in Patients with Pyogenic Liver Abscess

Proton-pump inhibitors (PPIs) are generally safe and well tolerated. Many adverse associations with long-term PPI use, such as dementia, have been reported but not replicated in follow-up studies. Yet other adverse associations, such as infectious complications of cirrhosis (pneumonia, spontaneous bacterial peritonitis, and pyogenic liver abscess [PLA]) have been observed in several studies and have biologic plausibility (reduced gastric acidity enables bacterial overgrowth/translocation).

In the current retrospective study, researchers evaluated whether PPI use was associated with mortality risk in over 180 patients with newly diagnosed PLA, 55% of whom were taking a PPI (90% pantoprazole). Sixty-two percent of PPI users had no clear indica…