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Proton pump inhibitor use significantly increases the risk of cryptogenic liver abscess: a population‐based study
Author(s) -
Wang Y.P.,
Liu C.J.,
Chen T.J.,
Lin Y.T.,
Fung C.P.
Publication year - 2015
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.13203
Subject(s) - medicine , odds ratio , liver abscess , confidence interval , proton pump inhibitor , abscess , population , pyogenic liver abscess , gastroenterology , surgery , environmental health
Summary Background Proton pump inhibitors ( PPI s) increase gastric pH and impair defence mechanisms against ingested pathogens, which may result in the overgrowth of virulent Klebsiella pneumoniae in the intestine and subsequent liver abscess. Aim We investigated the possible association between PPI s use and cryptogenic liver abscess in Taiwan. Methods We conducted a population‐based case–control study using data from the National Health Insurance Research Database. A total of 958 adult cases of liver abscess and 3832 age‐ and sex‐matched control patients were enrolled during 2000–2010. Conditional logistic regression was used to estimate the adjusted odds ratios ( OR s) in patients using PPI s before cryptogenic liver abscess. Results The adjusted OR associating current use of PPI s (prescription within the past 30 days) with cryptogenic liver abscess was 4.7 [95% confidence interval ( CI ), 2.9–7.8], and recent use of PPI s (prescription within the past 31–90 days) with cryptogenic liver abscess was 2.9 (95% CI , 1.4–6.1). A dose–response relationship was apparent for cumulative dose of PPI s within 90 days. Adjusted OR was highest among the patients receiving PPI s more than 60 cumulative defined daily dose ( OR = 6.5, 95% CI , 2.8–14.9). Conclusion Proton pump inhibitor therapy within the past 90 days was associated with an increased risk of cryptogenic liver abscess.