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Proton Pump Inhibitors Raise Gastroenteritis Risk

Suppressing acid with histamine-2 receptor antagonists does not have same effect

WEDNESDAY, Dec. 5 (HealthDay News) -- Acid-suppressing proton pump inhibitors raise the risk of Campylobacter and Salmonella gastroenteritis, but histamine-2 receptor antagonists do not have this effect, according to a report published in the December issue of Clinical Gastroenterology and Hepatology.

Luis Alberto Garcia Rodriguez, M.D., of the Centro Espanol de Investigacion Farmacoepidemiologica in Madrid, Spain, and colleagues conducted a study of 6,414 patients with acute bacterial gastroenteritis who were matched with 50,000 controls.

For patients treated with proton pump inhibitors, the risk of developing bacterial gastroenteritis was 2.9 times higher than those not taking the drug. The relative risk for omeprazole was 3.0 and for lansoprazole it was 2.1. Doubling the dose raised the relative risk to 5.0. There was no such association with the use of histamine-2 receptor antagonists cimetidine or ranitidine.

Of those who developed bacterial gastroenteritis, 4,125 were caused by Campylobacter and 1,885 were due to Salmonella. Only 31 cases were attributed to Clostridium.

Given that histamine-2 receptor antagonists are associated with less gastric acid suppression than proton pump inhibitors, the findings are "consistent with the role of gastric acid as a major mechanism of defense against ingested organisms," the authors conclude.

This study was supported in part by a research grant from Astra-Zeneca R&D, Sweden.

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