Hospitalized patients are often placed on acid-suppressive medications to prevent the development of ulcers. However, in many of these patients, there is no clear evidence supporting the need for ulcer prophylaxis. In fact, in the absence of an accepted indication for acid suppression, these medications may do more harm than good.

Hospitalized patients are often placed on acid-suppressive medications to prevent the development of ulcers. However, in many of these patients, there is no clear evidence supporting the need for ulcer prophylaxis. In fact, in the absence of an accepted indication for acid suppression, these medications may do more harm than good.

According to a study in the May 27, 2009 issue of the Journal of the American Medical Association, acid-suppressive medication use among hospitalized patients may increase the risk of hospital-acquired pneumonia.

Investigators from Beth Israel Deaconess Medical Center in Boston, Massachusetts and Harvard Medical School performed a prospective cohort study of all patients 18 years and over who were admitted to their medical center and hospitalized for at least three days from January 2004 through December 2007. Admissions requiring time in the intensive care unit were excluded. The final cohort consisted of 63,878 admissions, and acid-suppressive medications were prescribed in 52% of these admissions. The investigators found that the incidence of hospital-acquired pneumonia was 30% higher in the group exposed to acid-suppressive medication, including both histamine2 receptor antagonists and proton-pump inhibitors. However, the association only reached statistical significance for proton-pump inhibitor use.

The reasons behind this possible association between acid-suppressive medication use and hospital-acquired pneumonia are not clear. Still, this study highlights the importance of carefully considering the indications for acid-suppressive medications, particularly proton-pump inhibitors, rather than routinely administered them to all hospitalized patients.

Source:

JAMA. 2009;301(20):2120-2128.