title: Proton pump inhibitors and gastroenteritis.
abstract: An association between proton pump inhibitor (PPI) therapy and bacterial gastroenteritis has been suggested as well as contradicted. The aim of this study was to examine the association between the use of PPIs and occurrence of bacterial gastroenteritis in the prospective Rotterdam Study. The Rotterdam Study is a population-based cohort study among 14,926 subjects aged 45 years and older with up to 24 years of follow-up. Analyses were performed with a generalized estimating equations method in participants who handed-in a diagnostic stool sample. Furthermore, a nested case-control analysis was performed using the total cohort as a reference group. A bacterial microorganism was isolated in 125 samples, whereas 1174 samples were culture negative. In the generalized estimating equations analysis, we found that participants with a bacterial gastroenteritis were more likely than controls to be current users of PPIs (adjusted OR 1.94; 95 % CI 1.15-3.25). Different sensitivity analyses did not change this result. A considerably higher effect was observed (adjusted OR 6.14; 95 % CI 3.81-9.91), using the total cohort as a reference in a nested case-control analysis. Current PPI therapy is associated with an increased risk of bacterial gastroenteritis. However, by reducing the risk of selection and information bias in our study design, we demonstrated that the effect is lower than previously assumed.
authors.affiliation: Department of Epidemiology, Erasmus Medical Centre, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands.|Department of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands.
authors.forename: Robert-Jan
authors.initials: RJ
authors.lastname: Hassing
authors.affiliation: Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Annelies
authors.initials: A
authors.lastname: Verbon
authors.affiliation: Star Medisch Diagnostisch Centrum, Rotterdam, The Netherlands.
authors.forename: Herman
authors.initials: H
authors.lastname: de Visser
authors.affiliation: Department of Epidemiology, Erasmus Medical Centre, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Department of Epidemiology, Erasmus Medical Centre, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands. b.stricker@erasmusmc.nl.|Inspectorate of Health Care, Utrecht, The Netherlands. b.stricker@erasmusmc.nl.
authors.forename: Bruno H
authors.initials: BH
authors.lastname: Stricker
mesh_terms: D000368:Aged; D002169:Campylobacter Infections / Q000139:chemically induced; D016022:Case-Control Studies; D004405:Dysentery, Bacillary / Q000139:chemically induced; D005243:Feces / Q000382:microbiology; D005260:Female; D005759:Gastroenteritis / Q000139:chemically induced* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D012480:Salmonella Infections / Q000139:chemically induced; D015009:Yersinia Infections / Q000139:chemically induced
chemical_list: D054328:Proton Pump Inhibitors
keywords: Campylobacter; Cohort study; Gastroenteritis; Proton pump inhibitor; Salmonella