Perspective about safety of PPIs is changing, say Danish researchers

PPI proton pump inhibitor Perspective about safety of PPIs is changing, say Danish researchersEarlier this month in the British Journal of Clinical Pharmacology, researchers from Scotland and England published their findings that popular acid reducing drugs proton pump inhibitors, or PPIs, increase the risk of food poisoning by nearly four times.

Now in Clinical Infectious Diseases, researchers from Denmark are publishing similar findings. Anne Kvistholm Jensen, PhD, of the department of infectious disease epidemiology at Statens Serum Institut, Copenhagen, Denmark, and colleagues have conducted another study linking the drugs to an increased risk for listeriosis, a serious infection usually caused by eating food contaminated with the bacterium Listeria monocytogenes.

“PPIs reduce gastric acid secretion and it is hypothesized that this may enhance survival of acid-sensitive pathogens including L. monocytogenes when passing through the stomach and thus increases the risk of disease,” the researchers wrote, according to Healio.

According to the researchers, since the early 2000s an increase in occurrence of the disease in several European countries, including Denmark, has been attributed to the growing popularity of PPIs. There are around 60 million prescriptions for these drugs, which include the name brands Prevacid, Nexium and Prilosec, sold a year in England according to the Daily Mail. This only accounts for a fraction of actual usage as they are also available in over-the-counter form.

Jensen and colleagues studied records from Danish health registries from 1994 to 2012, analyzing 721 case-patients aged 45 years or older with specimens that tested positive for L. monocytogenes and 34,844 matched controls. They found that compared to nonusers those currently on PPIs were nearly three times more likely to develop listeriosis. They also found that the association between PPI use and listeriosis remained significant up to 90 days after the last date of prescription redemption.

“PPIs have been regarded as generally safe and without serious adverse effects. However, this perspective is changing,” Jensen and colleagues concluded, according to Healio. “Evidence is mounting that PPIs can have a biologic, causal effect on the risk of enteric infections including foodborne infections such as salmonellosis, campylobacteriosis and listeriosis.”

The Healio article said that the researchers also warned against other adverse events linked to PPIs including an increased risk for acute and chronic kidney disease, hypomagnesemia, bone fracture, community-acquired pneumonia and Clostridium difficile infection.

Oxford Journals
Daily Mail