Digestive Diseases and Sciences

, Volume 53, Issue 2, pp 394–398

Association between Proton Pump Inhibitor Use and Spontaneous Bacterial Peritonitis

Authors

  • Mical S. Campbell
    • Department of MedicineUniversity of Pennsylvania
    • Division of GastroenterologyHospital of the University of Pennsylvania
  • Keith Obstein
    • Department of MedicineUniversity of Pennsylvania
  • K. Rajender Reddy
    • Department of MedicineUniversity of Pennsylvania
    • Division of GastroenterologyHospital of the University of Pennsylvania
    • Department of MedicineUniversity of Pennsylvania
    • Center for Clinical Epidemiology and BiostatisticsUniversity of Pennsylvania
    • Division of GastroenterologyHospital of the University of Pennsylvania
Original Paper

DOI: 10.1007/s10620-007-9899-9

Cite this article as:
Campbell, M.S., Obstein, K., Reddy, K.R. et al. Dig Dis Sci (2008) 53: 394. doi:10.1007/s10620-007-9899-9

Abstract

Proton pump inhibitors (PPIs) increase enteric bacterial colonization, overgrowth, and translocation, all effects which might predispose to spontaneous bacterial peritonitis. We investigated whether PPI usage is associated with spontaneous bacterial peritonitis. Our retrospective case-control study included 116 consecutive cirrhotic patients with ascites who underwent diagnostic paracentesis upon hospital admission (2002–2005). Spontaneous bacterial peritonitis was defined as paracentesis yielding ≥250 polymorphonuclear leukocytes/ml. We performed logistic regression to determine the risk of spontaneous bacterial peritonitis by PPI usage. Of the 116 subjects, 32 had spontaneous bacterial peritonitis. Patient characteristics were similar between groups with and without infection, with the exception of the Model for End-Stage Liver Disease score (median: 23 and 18, respectively; P = 0.002). Crude and adjusted odds ratios for the development of spontaneous bacterial peritonitis by exposure to PPIs were 1.22 (95% confidence interval: 0.52–2.87) and 1.05 (0.43–2.57), respectively. In conclusion, we did not find a positive association between PPI use and spontaneous bacterial peritonitis.

Keywords

Acid suppressionAscitesCirrhosisHeartburnProton pump inhibitorsSpontaneous bacterial peritonitis)

Abbreviations

H2RA

Histamine 2 receptor antagonist

MELD

Model for end-stage liver disease

PMN

Polymorphonuclear leukocytes

PPI

Proton pump inhibitor

SBP

Spontaneous bacterial peritonitis

Copyright information

© Springer Science+Business Media, LLC 2007