PPIs, Other Acid Blockers Linked to Pneumonia Risk

We have long reported about the problems associated with <"http://www.yourlawyer.com/topics/overview/Proton_pump_inhibitors">proton pump inhibitors (PPIs) and adverse reactions linked to bone loss, fracture risk, and increased pneumonia risks. A new study has found that about 33,000 deaths occur annually as a result of hospital-acquired pneumonia linked to PPIs.

WebMD said the deaths could be a result of PPIs and other acid suppressants being prescribed during hospital stays to patients not necessarily in need of such medication. It is known that PPIs such as Prilosec and Nexium were investigated by the U.S. Food and Drug Administration (FDA) for suspected links to cardiac trouble and, in the past, we’ve reported that because the drugs may be overly effective at stopping stomach acid production, they are known to raise pneumonia, bone loss, and fracture risk by over 40 percent in patients on long-term use.

WebMD explained that routine prescription of PPIs during hospitalizations has been linked to an increased risk—30 percent—of acquiring pneumonia, citing the study, which appears in today’s The Journal of the American Medical Association. PPIs are prescribed to reduce risks associated with stress-related ulcers, which can be life threatening, said WebMD. PPIs have also been found to be routinely given to patients with what WebMD described as “a very low risk for developing the ulcers,” according to Shoshana J. Herzig, MD, study researcher with Beth Israel Deaconess Medical Center and Harvard School of Medicine.

The recent study is the first to look at the possibility of increased pneumonia risks in nonIntensive Care Unit (ICU) hospital patients not needing a ventilator to breathe, said WebMD. According to earlier studies, acid suppressants are prescribed to anywhere from 40-to-70 percent of all hospitalized patients in the U.S., said Web MD.

The team looked at medical records for nearly 64,000 non-ventilated, non-ICU adult patients who were hospitalized and treated at Beth Israel from 2004 to 2007 and found 52 percent were prescribed acid reducers. Of these, most—83 percent—were prescribed PPIs such as Aciphex, Nexium, Prevacid, Prilosec, and Protonix and 23 percent, acid-suppressives known as H2 blockers such as Axid, Pepcid, Tagamet, and Zantac, reported WebMD. The vast majority—nine of 10—were prescribed the drugs within 48 hours following admission.

Of the 40 million hospital patients discharged annually in the U.S., about one in five who develops hospital-acquired pneumonia will die, Web MD pointed out, translating into about 180,000 cases of hospital-acquired pneumonia and 33,000 deaths annually, the researchers concluded. Some believe pneumonia risk is increased because reducing stomach acids might allow other bacteria to fester in the upper gastrointestinal and upper respiratory tract, or by suppressing coughs, a symptom of acid reflux and which clears the lungs, explained Herzig, said WebMD.

A recent Canadian study of PPIs and osteoporosis-related fractures revealed a link between long-term PPI use and increased risk for hip, wrist, or spine fractures. We also wrote earlier this month that Plavix (clopidogrel) users were warned by the Society for Cardiovascular Angiography and Interventions (SCAI) to avoid PPIs following stent implantation because the combination increases the risks for heart attack (by 70 percent), stroke (48 percent), and other cardiovascular problems (repeat heart procedures by 35 percent), according to a prior HealthDay News report.

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