Suppressing stomach acid may up intestinal growth of MDROs

(HealthDay)—Stomach acid suppression medications increase the odds of intestinal colonization with multidrug-resistant microorganisms (MDROs), according to a review and meta-analysis recently published in JAMA Internal Medicine.

Roel P.J. Willems, M.D., from the Amsterdam University Medical Centers, and colleagues analyzed data from 26 observational studies to examine the association between the use of gastric acid suppressants and the risk of intestinal colonization with MDROs.

The researchers found that 38.9 percent of patients in the included studies were acid suppressant users. Among the 22,305 patients who were included in a primary meta-analysis, acid suppression increased the odds of intestinal carriage of MDROs of the Enterobacterales order and of vancomycin-resistant enterococci by 75 percent (odds ratio, 1.74). A pooled analysis including 29,382 patients supported this finding (odds ratio, 1.70). Variations in study setting and the type of acid suppression partially explained heterogeneity.

"While proton pump inhibitors are generally safe, even rare infectious and noninfectious adverse events are important on a population level given their wide use," write the authors of an accompanying editorial. "It is well established that proton pump inhibitors are overprescribed, and given their known association with a variety of adverse reactions, the important issue is how we can decrease inappropriate use."

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