Absence of gastrointestinal infections in a cohort of patients with Zollinger-Ellison syndrome and other acid hypersecretors receiving long-term acid suppression with lansoprazole.
BACKGROUND
The relationship between proton pump inhibitor therapy and other acid suppressing medications and the risk of gastrointestinal infections remains controversial.


METHODS
Patients enrolled in a long-term trial of lansoprazole for Zollinger-Ellison syndrome and other acid hypersecretory states had interval histories taken every six months regarding hospitalizations or other intercurrent medical conditions. All medications taken were also reviewed at each visit. In addition, available patients were specifically queried during the study period 2006-2007 regarding the development of any gastrointestinal infections, hospitalizations, and prescriptions for antibiotics.


RESULTS
Ninety patients were enrolled in our long-term study and 81 were available for review. The median basal gastric pH for the cohort after stabilization on therapy was 2.9 and ranged from 1.1 - 8.4 with a median pentagastrin stimulated gastric pH of 1.60 (range 1.0 - 8.2). No patient developed a clinically significant gastrointestinal infection during the study. The median patient years of follow-up were 6.25 years.


CONCLUSIONS
In a cohort of patients with gastric acid hypersecretion in whom acid secretion status was monitored on lansoprazole, all were free of significant gastrointestinal infections on long-term follow-up.


BACKGROUND
NCT00204373.
Wilcox
C Mel
CM
Department of Medicine, Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama, USA. melw@uab.edu
Martin
Toni
T
Phadnis
Milind
M
Mohnen
Jean
J
Worthington
Julie
J
Hirschowitz
Basil I
BI
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D016360:Clostridioides difficile / Q000472:pathogenicity; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005744:Gastric Acid / Q000378:metabolism*; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology*; D041981:Gastrointestinal Tract / Q000382:microbiology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D015994:Incidence; D064747:Lansoprazole; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D015043:Zollinger-Ellison Syndrome / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000890:Anti-Infective Agents; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D064747:Lansoprazole