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PPI Infection Control

PPI Infection Control

gastroenterologist

Does a drug routinely given in the hospital increase a person’s risk of dying there? The huge number of hospitalizations each year, around 35 million, may be burying a significant number of deaths related to the use of a proton pump inhibitor, or PPI, during the stay.

According to the U.S. Food and Drug Administration, proton pump inhibitors treat gastrointestinal disorders by reducing the amount of acid in the stomach. This lowers the odds of a gastrointestinal bleed brought on the stress of hospitalization, especially if the patient has a pre-existing condition that puts them at risk for a GI bleed. A complication like a bleeding gut increases the likelihood of dying in the hospital, but there is some indication that the medicine to lower that risk creates a new problem.

The Link Between Proton Pump Inhibitors and Infection

While proton pump inhibitors are a reliable choice to control potential stomach problems, a side effect of the drug is an increased risk of infection. The same mechanism that allows the drug to reduce stomach acid production creates an environment that promotes bacterial growth.

The risk of a healthcare-associated infection is already prevalent during a hospital stay. The Centers for Disease Control and Prevention states that one in every 25 hospitalized patients will develop at least one HAI, some of which will be life-threatening. It is estimated that one in every five patients receives a proton pump inhibitor during their stay adding to that risk.

What Study Shows About PPIs

A study conducted by the University of Michigan Medical School and VA Ann Arbor Healthcare System utilized a model to simulate the risk of death related to PPI use in large patient populations. Researchers found that for the majority patients adding a PPI to their care plan created a perfect storm for infections. Although, the goal of this treatment is to lower a patient’s risk of dying due to a complication in the hospital, the drug actually does the opposite. Taking a proton pump inhibitor raises the risk of death from a healthcare-associated infection.

The study numbers were not that impressive, roughly one in every 831 hospital patients taking a PPI for the first time during their stay and one in 3,625 that continues to take it in the hospital would succumb to infection. One of the study authors Dr. Matthew Pappa points out that the numbers were consistent, though, and given a large number of hospitalizations in the U.S. each year, even that small number of deaths becomes very significant.

The study has led some gastroenterologists to question the wisdom of prescribing a PPI proactively. The drugs are effective in reducing the symptoms of heartburn and the risk of peptic ulcers, but over prescribing them may create a short-term risk of acquiring an infection that will lengthen the patient’s hospital stay and can create long-term problems or even lead to death.

 





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