Risk for hospital-acquired pneumonia from proton pump inhibitor or sucralfate in intensive care units

Li Mei Lin, Li Wei Chen, Yu Chin Liu, Kuang Hung Hsu, Chong Yu Hsieh, Hsiang Yin Chen

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

The increased risk of pneumonia from proton pump inhibitors (PPI) has been addressed in recent studies. This study aimed to investigate the risk of hospital-acquired pneumonia (HAP) in critically ill patients receiving PPI or sucralfate. This retrospective observational cohort study analyzed patients who were prescribed with PPIs or sucralfate for stress ulcer prophylaxis in intensive care units (ICU). A propensity score and other risk factors were used to calculate the adjusted odds ratio (OR) for the two groups. The final cohort comprised 388 patients with 302 patients on PPI and 86 patients on sucralfate therapies. HAP developed in 63 patients (20.86%) on PPI, and 8 patients (9.30%) on sucralfate (adjusted OR 3.37, 95% CI 1.35-8.45, p-value 0.009). The enrolled patients on PPI therapy with an APACHE II score > 13 (adjusted OR 3.70, 95% CI 1.04-13.10, p-value 0.043), or those on PPI therapy with an ICU stay of more than 8 days (adjusted OR 9.04, 95% CI 1.94-42.06, p-value 0.005) had the highest risk of developing HAP. Patients in medical ICU treated with PPIs had a higher risk of developing HAP than those treated with sucralfate. For the ICU patients requiring stress ulcer prophylaxis, sucralfate can be considered as a priority treatment. The risk and benefit of PPI treatment should be evaluated for patients who may have a longer ICU stay or have a high APACHE II score.

Original languageEnglish
JournalJournal of Food and Drug Analysis
Volume20
Issue number3
DOIs
Publication statusPublished - Sep 2012

Fingerprint

Sucralfate
Proton Pump Inhibitors
pneumonia
Intensive Care Units
Pneumonia
odds ratio
Odds Ratio
APACHE
therapeutics
Ulcer
disease control
proton pump inhibitors
Therapeutics
Propensity Score
cohort studies
Critical Illness
Observational Studies
Cohort Studies
risk factors

Keywords

  • Acid-suppressive pharmacologic agents
  • Hospital-acquired pneumonia
  • Pneumonia
  • Proton pump inhibitor
  • Stress ulcer prophylaxis
  • Sucralfate

ASJC Scopus subject areas

  • Food Science
  • Pharmacology

Cite this

Risk for hospital-acquired pneumonia from proton pump inhibitor or sucralfate in intensive care units. / Lin, Li Mei; Chen, Li Wei; Liu, Yu Chin; Hsu, Kuang Hung; Hsieh, Chong Yu; Chen, Hsiang Yin.

In: Journal of Food and Drug Analysis, Vol. 20, No. 3, 09.2012.

Research output: Contribution to journalArticle

Lin, Li Mei ; Chen, Li Wei ; Liu, Yu Chin ; Hsu, Kuang Hung ; Hsieh, Chong Yu ; Chen, Hsiang Yin. / Risk for hospital-acquired pneumonia from proton pump inhibitor or sucralfate in intensive care units. In: Journal of Food and Drug Analysis. 2012 ; Vol. 20, No. 3.
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abstract = "The increased risk of pneumonia from proton pump inhibitors (PPI) has been addressed in recent studies. This study aimed to investigate the risk of hospital-acquired pneumonia (HAP) in critically ill patients receiving PPI or sucralfate. This retrospective observational cohort study analyzed patients who were prescribed with PPIs or sucralfate for stress ulcer prophylaxis in intensive care units (ICU). A propensity score and other risk factors were used to calculate the adjusted odds ratio (OR) for the two groups. The final cohort comprised 388 patients with 302 patients on PPI and 86 patients on sucralfate therapies. HAP developed in 63 patients (20.86{\%}) on PPI, and 8 patients (9.30{\%}) on sucralfate (adjusted OR 3.37, 95{\%} CI 1.35-8.45, p-value 0.009). The enrolled patients on PPI therapy with an APACHE II score > 13 (adjusted OR 3.70, 95{\%} CI 1.04-13.10, p-value 0.043), or those on PPI therapy with an ICU stay of more than 8 days (adjusted OR 9.04, 95{\%} CI 1.94-42.06, p-value 0.005) had the highest risk of developing HAP. Patients in medical ICU treated with PPIs had a higher risk of developing HAP than those treated with sucralfate. For the ICU patients requiring stress ulcer prophylaxis, sucralfate can be considered as a priority treatment. The risk and benefit of PPI treatment should be evaluated for patients who may have a longer ICU stay or have a high APACHE II score.",
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