Are proton pump inhibitors associated with the development of community-acquired pneumonia? A meta-analysis
Are proton pump inhibitors associated with the development of community-acquired pneumonia? A meta-analysis
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DOI：
10.1586/ecp.12.20
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发表时间：
2012-05-01
影响因子：
4.4
通讯作者：
Kale-Pradhan, Pramodini B.
中科院分区：
文献类型：
--
作者：
Giuliano, Christopher;Wilhelm, Sheila M.;Kale-Pradhan, Pramodini B.
这项研究于2011年10月在匹兹堡（PA，美国）举行的美国胸科医师学会会议上发表。研究目的是评价质子泵抑制剂（PPI）与社区获得性肺炎（CAP）的相关性。研究设计是对9项病例对照和队列研究的荟萃分析。1987年至2006年的120，863例肺炎病例被纳入荟萃分析。由两名研究者独立使用关键词：PPI、肺炎、CAP、抗溃疡药、抗酸药、奥美拉唑、埃索美拉唑、兰索拉唑、泮托拉唑和雷贝拉唑，检索PubMed和奥维德Medline，从开始到2011年5月。该荟萃分析仅包括以英文全文发表的病例对照和队列研究，并评价了PPI使用和CAP发生率。如果研究包括以下患者，则将其排除：儿童、幽门螺杆菌治疗和危重患者。手动检索近期综述文章和系统性综述的参考书目。研究质量采用Newcastle-Ottawa质量评估量表进行评估。两名研究者独立地将数据提取到标准化数据收集表中，并由第三名研究者确认。根据PPI的当前使用、PPI使用持续时间（180天）和PPI剂量（高vs低）分析数据。使用随机效应模型（综合Meta分析（R）2.0版）分析PPI和CAP的总体相关性。9项研究符合主要结局的所有标准。Newcastle-Ottawa Quality Assessment Scale评分范围为4 - 8分（满分9分）。当前使用PPI（比值比[OR]：1.39; 95% CI：1.09-1.76），PPI使用> 180天（OR：1.10; 95% CI：1.00-1.21）。总之，目前接受PPI的患者，特别是
This study was presented at the American College of Chest Physicians meeting in Pittsburgh (PA, USA) in October 2011. The study objective was to evaluate the association of proton pump inhibitors (PPIs) and community-acquired pneumonia (CAP). The design was a meta-analysis of nine case-controlled and cohort studies. 120,863 pneumonia cases from 1987 to 2006 were included in the meta-analysis. PubMed and Ovid Medline were searched from inception through May 2011 by two investigators independently using keywords: PPI, pneumonia, CAP, anti-ulcer, antacid, omeprazole, esomeprazole, lansoprazole, pantoprazole and rabeprazole. This meta-analysis only included case-controlled and cohort studies that were published in full in English and evaluated PPI use and CAP incidence. Studies were excluded if they included the following patients: pediatric, Helicobacter pylori treatment and critically ill. Bibliographies of recent review articles and systematic reviews were hand-searched. Quality of studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. Two investigators independently extracted data into standardized data collection forms that were confirmed by a third investigator. Data were analyzed based on current use of PPIs, duration of PPI use (180 days) and PPI dose (high vs low). Overall association of PPI and CAP was analyzed using the random effects model (Comprehensive Meta analysis (R) Version 2.0). Nine studies met all criteria for the primary outcome. Newcastle-Ottawa Quality Assessment Scale scores ranged from 4 to 8 out of 9. Current use of PPIs (odds ratio [OR]: 1.39; 95% CI: 1.09-1.76), PPI use 180 days (OR: 1.10; 95% CI: 1.00-1.21). In conclusion, patients currently receiving PPIs, particularly