title: Gastric acid, acid-suppressing drugs, and bacterial gastroenteritis: how much of a risk?
abstract: Recent studies have reported an association between acid-suppressing drugs (histamine H2 receptor antagonists and proton pump inhibitors) and development of infectious gastroenteritis. We conducted a case-control study nested in a cohort of more than 170,000 ever-users of acid-suppressing drugs to examine the association between acid-suppressing drugs and bacterial gastroenteritis, using data from the General Practice Research Database in the United Kingdom. We identified 374 confirmed cases of bacterial gastroenteritis and 2,000 randomly sampled controls from the study cohort. There was little increased risk of bacterial gastroenteritis among users of acid-suppressing drugs [relative risk (RR) = 1.1; 95% confidence interval (CI) = 0.8-1.4]. Omeprazole "single users" had an RR of 1.6 (95% CI = 1.0-2.4), but this effect was not observed among those using only omeprazole during the last year (RR = 1.1; 95% CI = 0.7-1.9). We did not find any dose or treatment duration response. These data do not support a major role for acid reduction in the development of bacterial gastroenteritis.
authors.affiliation: Centro Español de Investigación Farmacoepidemiológica, Universidad Complutense, Madrid, Spain.
authors.forename: L A
authors.initials: LA
authors.lastname: Garcia Rodríguez
authors.forename: A
authors.initials: A
authors.lastname: Ruigómez
mesh_terms: D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems; D000368:Aged; D000897:Anti-Ulcer Agents / Q000009:adverse effects*; D001424:Bacterial Infections / Q000139:chemically induced* / Q000382:microbiology; D016022:Case-Control Studies; D005194:Family Practice; D005260:Female; D005744:Gastric Acid; D005759:Gastroenteritis / Q000139:chemically induced* / Q000382:microbiology; D006635:Histamine H2 Antagonists / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors; D012306:Risk; D012307:Risk Factors; D006113:United Kingdom
chemical_list: D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors