Use of proton pump inhibitors and the risk of community-acquired pneumonia - A population-based case-control study
Use of proton pump inhibitors and the risk of community-acquired pneumonia - A population-based case-control study
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DOI：
10.1001/archinte.167.9.950
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发表时间：
2007-05-14
影响因子：
--
通讯作者：
Hallas, Jesper
中科院分区：
文献类型：
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作者：
Gulmez, Sinem Ezgi;Holm, Anette;Hallas, Jesper
背景：最近，质子泵抑制剂（PPI）的使用与肺炎风险增加有关。我们的目的是确认这种关联，并确定的风险factors.Methods：我们进行了一项基于人群的病例对照研究，使用的数据从县的Funen，丹麦。病例（n = 7642）定义为2000年至2004年期间首次出院诊断为社区获得性肺炎的所有患者。我们还选择了34176名对照受试者，他们的年龄和性别与病例的频率相匹配。关于PPI和其他药物使用、微生物样本、X线检查结果和共病状况的数据均来自当地登记研究。结果：目前使用PPI与社区获得性肺炎相关的调整优势比（OR）为1.5（95%置信区间[ CI]，1.3-1.7）。未发现与组胺（2）受体拮抗剂（OR，1.10; 95% CI，0.8-1.3）或既往使用PPI（OR，1.2; 95% CI，0.9-1.6）相关。近期开始PPI治疗（索引日期前0-7天）与社区获得性肺炎的相关性特别强（OR，5.0; 95% 2.1-11.7），而在很久以前开始治疗的风险降低（OR，1.3; 95% CI，1.2-1.4）。亚组分析显示，40岁以下使用者的OR较高（OR，2.3; 95% CI，1.3-4.0）。没有剂量反应效应可以被证明。结论：PPI的使用，特别是当最近开始，与社区获得性肺炎的风险增加。
Background: Recently, the use of proton pump inhibitors ( PPIs) has been associated with an increased risk of pneumonia. We aimed to confirm this association and to identify the risk factors.Methods: We conducted a population-based case-control study using data from the County of Funen, Denmark. Cases ( n = 7642) were defined as all patients with a first-discharge diagnosis of community-acquired pneumonia from a hospital during 2000 through 2004. We also selected 34 176 control subjects, who were frequency matched to the cases by age and sex. Data on the use of PPIs and other drugs, on microbiological samples, on x-ray examination findings, and on comorbid conditions were extracted from local registries. Confounders were controlled by logistic regression.Results: The adjusted odds ratio ( OR) associating current use of PPIs with community-acquired pneumonia was 1.5 ( 95% confidence interval [ CI], 1.3-1.7). No association was found with histamine(2)-receptor antagonists ( OR, 1.10; 95% CI, 0.8-1.3) or with past use of PPIs ( OR, 1.2; 95% CI, 0.9-1.6). Recent initiation of treatment with PPIs ( 0-7 days before index date) showed a particularly strong association with community-acquired pneumonia ( OR, 5.0; 95% 2.1-11.7), while the risk decreased with treatment that was started a long time ago ( OR, 1.3; 95% CI, 1.2-1.4). Subgroup analyses revealed high ORs for users younger than 40 years ( OR, 2.3; 95% CI, 1.3-4.0). No dose-response effect could be demonstrated.Conclusion: The use of PPIs, especially when recently begun, is associated with an increased risk of community-acquired pneumonia.