Digestive Diseases and Sciences

, Volume 53, Issue 2, pp 394–398 | Cite as

Association between Proton Pump Inhibitor Use and Spontaneous Bacterial Peritonitis

  • Mical S. Campbell
  • Keith Obstein
  • K. Rajender Reddy
  • Yu-Xiao Yang
Original Paper

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 suppression Ascites Cirrhosis Heartburn Proton pump inhibitors Spontaneous 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

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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Mical S. Campbell
    • 1
    • 3
  • Keith Obstein
    • 1
  • K. Rajender Reddy
    • 1
    • 3
  • Yu-Xiao Yang
    • 1
    • 2
    • 3
  1. 1.Department of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Center for Clinical Epidemiology and BiostatisticsUniversity of PennsylvaniaPhiladelphiaUSA
  3. 3.Division of GastroenterologyHospital of the University of PennsylvaniaPhiladelphiaUSA

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