PMID- 20222914
OWN - NLM
STAT- MEDLINE
DCOM- 20110105
LR  - 20100603
IS  - 1365-2036 (Electronic)
IS  - 0269-2813 (Linking)
VI  - 31
IP  - 11
DP  - 2010 Jun
TI  - Meta-analysis: proton pump inhibitor use and the risk of community-acquired 
      pneumonia.
PG  - 1165-77
LID - 10.1111/j.1365-2036.2010.04284.x [doi]
AB  - BACKGROUND: Observational studies examining the association between proton pump 
      inhibitor (PPI) use and risk of community-acquired pneumonia are conflicting. 
      AIM: To assess systematically the association between risk of community-acquired 
      pneumonia and PPI use in adults. METHODS: We searched MEDLINE, EMBASE and CINAHL 
      databases between 1988 and January 2010. Two reviewers independently selected 
      studies based on eligibility criteria and extracted data. Included studies 
      evaluated adults (> or =18 years) who took PPIs as an out-patient. The primary 
      outcome was community-acquired pneumonia. Only observational studies with a 
      comparison arm were included. RESULTS: Over 2600 citations were reviewed. Six 
      studies were included. All were nested case-control studies. Meta-analysis found 
      an increased risk of community-acquired pneumonia associated with PPI use [OR 
      1.36 (95% CI 1.12-1.65)]; significant heterogeneity remained (I(2) 92%, P < 
      0.001). In exploratory subgroup analysis, short duration of use was associated 
      with an increased odds of community-acquired pneumonia [OR 1.92 (95% CI 
      1.40-2.63), I(2) 75%, P = 0.003], whereas chronic use was not [OR 1.11 (95% CI 
      0.90-1.38), I(2) 91%, P < 0.001], a significant interaction (P < 0.005). 
      CONCLUSIONS: Heterogeneity precluded interpretation of the summary statistic. 
      Exploratory analysis revealed that duration of PPI use may impact the risk of 
      community-acquired pneumonia, a finding that should be explored in future 
      studies.
FAU - Johnstone, J
AU  - Johnstone J
AD  - Department of Medicine, McMaster University, Hamilton, ON, Canada. 
      johnsj48@mcmaster.ca <johnsj48@mcmaster.ca>
FAU - Nerenberg, K
AU  - Nerenberg K
FAU - Loeb, M
AU  - Loeb M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20100304
PL  - England
TA  - Aliment Pharmacol Ther
JT  - Alimentary pharmacology & therapeutics
JID - 8707234
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Ulcer Agents/*adverse effects/therapeutic use
MH  - Case-Control Studies
MH  - Community-Acquired Infections/*chemically induced
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pneumonia/*chemically induced
MH  - Proton Pump Inhibitors/*adverse effects/therapeutic use
MH  - Risk Factors
MH  - Young Adult
EDAT- 2010/03/13 06:00
MHDA- 2011/01/06 06:00
CRDT- 2010/03/13 06:00
PHST- 2010/03/13 06:00 [entrez]
PHST- 2010/03/13 06:00 [pubmed]
PHST- 2011/01/06 06:00 [medline]
AID - APT4284 [pii]
AID - 10.1111/j.1365-2036.2010.04284.x [doi]
PST - ppublish
SO  - Aliment Pharmacol Ther. 2010 Jun;31(11):1165-77. doi: 
      10.1111/j.1365-2036.2010.04284.x. Epub 2010 Mar 4.