Risk of Enteric Infection in Patients with Gastric Acid Supressive Drugs: A Population-Based Case-Control Study

Long-term use of gastric-acid-suppressive drugs is known to be associated with several adverse effects. However, the association between enteric infection and acid suppression therapy is still uncertain. This study aimed to evaluate the association between gastric acid suppression and the risk of en...

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Autores principales:	Chia-Jung Kuo, Cheng-Yu Lin, Chun-Wei Chen, Chiu-Yi Hsu, Sen-Yung Hsieh, Cheng-Tang Chiu, Wey-Ran Lin
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	enteric infection proton pump inhibitor H2-receptor antagonists Medicine R
Acceso en línea:	https://doaj.org/article/b1b554b462c94e438ac64dda79c263b4
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spelling	oai:doaj.org-article:b1b554b462c94e438ac64dda79c263b42021-11-25T18:06:49ZRisk of Enteric Infection in Patients with Gastric Acid Supressive Drugs: A Population-Based Case-Control Study10.3390/jpm111110632075-4426https://doaj.org/article/b1b554b462c94e438ac64dda79c263b42021-10-01T00:00:00Zhttps://www.mdpi.com/2075-4426/11/11/1063https://doaj.org/toc/2075-4426Long-term use of gastric-acid-suppressive drugs is known to be associated with several adverse effects. However, the association between enteric infection and acid suppression therapy is still uncertain. This study aimed to evaluate the association between gastric acid suppression and the risk of enteric infection. <b>Materials and Methods:</b> We conducted a population-based case-control study using the data from Chang Gung Research Database (CGRD) in Taiwan. Between January 2008 and December 2017, a total of 154,590 adult inpatients (age > 18) were identified. A pool of potential eligible controls according to four propensity scores matching by sex, age, and index year were extracted (<i>n</i> = 89,925). Subjects with missing data or who received less than 7 days of proton pump inhibitors (PPIs) and/or H2-receptor antagonists (H2RAs) were excluded. Finally, 17,186 cases and 69,708 corresponding controls were selected for analysis. The use of PPIs and H2RAs, the result of microbiological samples, and co-morbidity conditions have been analyzed. Confounders were controlled by conditional logistic regression. <b>Results:</b> 32.84% of patients in the case group used PPIs, compared with 7.48% in the control group. Of patients in the case group, 9.9% used H2RAs, compared with 6.9% in the control group. Of patients in the case group, 8.3% used a combination of PPIs and H2RAs, compared with 2.7% in the control group. The most common etiological pathogens were <i>Enterococcus</i> (44.8%), <i>Clostridioides difficile</i> (34.5%), and <i>Salmonella</i> spp. (10.2%). The adjusted odds ratio (OR) for PPI use with enteric infection was 5.526 (95% confidence interval [CI], 5.274–5.791). For H2RAs, the adjusted odds ratio was 1.339 (95% confidence interval [CI], 1.261–1.424). Compared to the control group, persons with enteric infection had more frequent acid-suppressive agent usage. <b>Conclusions:</b> This study demonstrates that gastric-acid-suppressive drug use is associated with an increased risk of enteric infection after adjusting for potential biases and confounders.Chia-Jung KuoCheng-Yu LinChun-Wei ChenChiu-Yi HsuSen-Yung HsiehCheng-Tang ChiuWey-Ran LinMDPI AGarticleenteric infectionproton pump inhibitorH2-receptor antagonistsMedicineRENJournal of Personalized Medicine, Vol 11, Iss 1063, p 1063 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	enteric infection proton pump inhibitor H2-receptor antagonists Medicine R
spellingShingle	enteric infection proton pump inhibitor H2-receptor antagonists Medicine R Chia-Jung Kuo Cheng-Yu Lin Chun-Wei Chen Chiu-Yi Hsu Sen-Yung Hsieh Cheng-Tang Chiu Wey-Ran Lin Risk of Enteric Infection in Patients with Gastric Acid Supressive Drugs: A Population-Based Case-Control Study
description	Long-term use of gastric-acid-suppressive drugs is known to be associated with several adverse effects. However, the association between enteric infection and acid suppression therapy is still uncertain. This study aimed to evaluate the association between gastric acid suppression and the risk of enteric infection. <b>Materials and Methods:</b> We conducted a population-based case-control study using the data from Chang Gung Research Database (CGRD) in Taiwan. Between January 2008 and December 2017, a total of 154,590 adult inpatients (age > 18) were identified. A pool of potential eligible controls according to four propensity scores matching by sex, age, and index year were extracted (<i>n</i> = 89,925). Subjects with missing data or who received less than 7 days of proton pump inhibitors (PPIs) and/or H2-receptor antagonists (H2RAs) were excluded. Finally, 17,186 cases and 69,708 corresponding controls were selected for analysis. The use of PPIs and H2RAs, the result of microbiological samples, and co-morbidity conditions have been analyzed. Confounders were controlled by conditional logistic regression. <b>Results:</b> 32.84% of patients in the case group used PPIs, compared with 7.48% in the control group. Of patients in the case group, 9.9% used H2RAs, compared with 6.9% in the control group. Of patients in the case group, 8.3% used a combination of PPIs and H2RAs, compared with 2.7% in the control group. The most common etiological pathogens were <i>Enterococcus</i> (44.8%), <i>Clostridioides difficile</i> (34.5%), and <i>Salmonella</i> spp. (10.2%). The adjusted odds ratio (OR) for PPI use with enteric infection was 5.526 (95% confidence interval [CI], 5.274–5.791). For H2RAs, the adjusted odds ratio was 1.339 (95% confidence interval [CI], 1.261–1.424). Compared to the control group, persons with enteric infection had more frequent acid-suppressive agent usage. <b>Conclusions:</b> This study demonstrates that gastric-acid-suppressive drug use is associated with an increased risk of enteric infection after adjusting for potential biases and confounders.
format	article
author	Chia-Jung Kuo Cheng-Yu Lin Chun-Wei Chen Chiu-Yi Hsu Sen-Yung Hsieh Cheng-Tang Chiu Wey-Ran Lin
author_facet	Chia-Jung Kuo Cheng-Yu Lin Chun-Wei Chen Chiu-Yi Hsu Sen-Yung Hsieh Cheng-Tang Chiu Wey-Ran Lin
author_sort	Chia-Jung Kuo
title	Risk of Enteric Infection in Patients with Gastric Acid Supressive Drugs: A Population-Based Case-Control Study
title_short	Risk of Enteric Infection in Patients with Gastric Acid Supressive Drugs: A Population-Based Case-Control Study
title_full	Risk of Enteric Infection in Patients with Gastric Acid Supressive Drugs: A Population-Based Case-Control Study
title_fullStr	Risk of Enteric Infection in Patients with Gastric Acid Supressive Drugs: A Population-Based Case-Control Study
title_full_unstemmed	Risk of Enteric Infection in Patients with Gastric Acid Supressive Drugs: A Population-Based Case-Control Study
title_sort	risk of enteric infection in patients with gastric acid supressive drugs: a population-based case-control study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/b1b554b462c94e438ac64dda79c263b4
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Risk of Enteric Infection in Patients with Gastric Acid Supressive Drugs: A Population-Based Case-Control Study

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