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<p>A new study concluded that the previously noted association between proton pump inhibitor use and community-acquired pneumonia is “likely to be due entirely to confounding factors.”</p>

PPI Use and Community-acquired Pneumonia Risks

December 8, 2016

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Proton pump inhibitor (PPI) use may not increase the risk of community-acquired pneumonia, according to a new study from researchers in the United Kingdom. In a cohort study spanning 1990-2013, 160,000 new PPI users were evaluated with three modalities: a multivariable Cox model comparing risk in PPI users with controls, a self-controlled case series, and a prior event rate ratio analysis over the 12-month periods before and after the first PPI prescription. The regression analysis showed a higher risk of pneumonia compared to controls (1.67 times higher for those exposed to PPI [95% confidence interval, 1.55-1.79]). But the other two analyses showed a lower risk. In the self-controlled study, the risk of pneumonia was almost twice as high in the 30 days prior to a PPI prescription (relative risk, 1.92; 95% confidence interval, 1.84-2.00). The prior event ratio also showed a higher risk of pneumonia the year prior to PPI use compared to the year after. The authors concluded that the previously noted association between PPI use and community-acquired pneumonia is “likely to be due entirely to confounding factors.” These factors may include gastroesophageal reflux disease. (BMJ 2016;355:i5813)