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Association Between Proton Pump Inhibitor Therapy and Spontaneous Bacterial Peritonitis Occurrence in Cirrhotic Patients: A Clinical Review

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Abstract

Spontaneous bacterial peritonitis (SBP) is one of the most common complications in patients with end-stage liver disease (ESLD), which increases the risk of short-term mortality. Proton pump inhibitors (PPIs) are frequently used in patients with ESLD, in which controversies about the risk of PPI treatment in the occurrence of SBP are largely raised and the pathogenic mechanism of PPI-associated SBP remains unclear. We conducted a systematic literature search through PubMed/MEDLINE for publications mainly from 1 January 2000 to 1 January 2021. Our narrative review summarized the adverse effect of specific PPI therapy on the occurrence and prognosis of SBP in cirrhotic patients, described the potential mechanisms by which PPI induces the development of SBP, and discussed the risk factors associated with the development of SBP and the strategy of PPI therapy in cirrhotic patients. Although controversy regarding the association between PPI use and the occurrence of SBP exists, PPIs use should be restricted to patients with clear benefit indications, and be cautious for elderly patients with severe liver damage.

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Authors and Affiliations

  1. Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei Province, China

    Meng Zhang, Wei Liu, Xin Xu, Tao Chen & Jun-ying Qi

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  1. Meng Zhang
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  2. Wei Liu
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  3. Xin Xu
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  4. Tao Chen
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Correspondence to Tao Chen or Jun-ying Qi.

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The authors have declared no competing interests in this work.

Author Tao CHEN is a member of Youth Editorial Committee for Current Medical Science. The paper was handled by the other editors and has undergone rigorous peer review process. Authors Tao CHEN were not involved in the journal’s review of, or decisions related to, this manuscript.

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Zhang, M., Liu, W., Xu, X. et al. Association Between Proton Pump Inhibitor Therapy and Spontaneous Bacterial Peritonitis Occurrence in Cirrhotic Patients: A Clinical Review. CURR MED SCI 42, 673–680 (2022). https://doi.org/10.1007/s11596-022-2607-3

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