Proton pump inhibitor therapy does not increase the incidence of spontaneous bacterial peritonitis in cirrhosis: a multicenter prospective study

Authors
Terg, Rubén; Casciato, Paola; Garbe, Cecilia; Cartier, Mariano; Stieben Teodoro; Mendizabal, Manuel; Niveyro, Carla; Benavides Javier; Colombato, Luis; Berbara, Daniel; Salgado, Pablo; Barreyro, Fernando Javier; Fassio, Eduardo; Gadano, Adrián Carlos
Publication Year
2015
Language
English
Format
article
Status
Published version
Description
BACKGROUND & AIM Retrospective studies show an association between proton pump inhibitor (PPI) therapy and spontaneous bacterial peritonitis (SBP). We investigate the relationship between PPI and SBP in decompensated cirrhotic patients in a large nationwide prospective study. METHODS: Seven hundred seventy patients with a diagnosis of decompensated cirrhosis were admitted consecutively in 23 hospitals in Argentina from March 2011 to April 2012; the patients were carefully investigated for PPI consumption in the previous 3 months. In total, 251 patients were excluded because of active gastrointestinal hemorrhage, antibiotic use during the preceding weeks, HIV-positive status and immunosuppressive therapy. RESULTS: Two hundred twenty-six out of 519 patients (43.5%) had received PPI therapy within the last 3 months. In 135 patients, PPIs were administered for longer than 2 weeks. A bacterial infection was shown in 255 patients (49.1%). SBP was diagnosed in 95 patients out of 394 patients with ascites (24.7%). There was no significant difference in the rate of PPI consumption between the infected and the non-infected patients (44.3% vs. 42.8%) or between the SBP patients and the patients with ascites without SBP (46% vs. 42%). In the SBP patients, the duration of PPI administration did not influence the rate of SBP occurrence. The type of bacteria and the origin of SBP infection were similar in the patients with and without PPI.CONCLUSION: In the current large, multicenter, prospective study, PPI therapy, specifically evaluated at admission of consecutive cirrhotic patients, was not associated with a higher risk of SBP.
Fil: Terg, Rubén. Gobierno de la Ciudad de Buenos Aires. Hospital de Gastroenterología ; Argentina
Fil: Casciato, Paola. Hospital Italiano; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Garbe, Cecilia. Ministerio de Salud de la Nación. Hospital Nacional Alejandro Posadas; Argentina
Fil: Cartier, Mariano. Gobierno de la Ciudad de Buenos Aires. Hospital de Gastroenterología ; Argentina
Fil: Stieben Teodoro. Provincia de Entre Rios. Ministerio de Salud. Hospital San Martín; Argentina
Fil: Mendizabal, Manuel. Hospital Universitario Austral; Argentina
Fil: Niveyro, Carla. Provincia de Misiones. Hospital Escuela de Agudos Dr. Ramon Madariaga; Argentina
Fil: Benavides Javier. Hospital Británico de Buenos Aires; Argentina
Fil: Colombato, Luis. Hospital Británico de Buenos Aires; Argentina
Fil: Berbara, Daniel. Provincia de Misiones. Hospital Escuela de Agudos Dr. Ramón Madariaga; Argentina
Fil: Salgado, Pablo. Gobierno de la Ciudad de Buenos Aires. Hospital de Gastroenterología ; Argentina
Fil: Barreyro, Fernando Javier. Hospital Británico de Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Fassio, Eduardo. Ministerio de Salud de la Nación. Hospital Nacional Alejandro Posadas; Argentina
Fil: Gadano, Adrián Carlos. Hospital Italiano; Argentina
Subject
CIRRHOSIS
PROTON PUMP INHIBITOR
SPONTANEOUS BACTERIAL PERITONITIS
Medicina Critica y de Emergencia
Medicina Clínica
CIENCIAS MÉDICAS Y DE LA SALUD
Access level
Restricted access
License
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repository
CONICET Digital (CONICET)
Institution
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identifier
oai:ri.conicet.gov.ar:11336/37473