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Proton pump inhibitors do not increase the risk for recurrent spontaneous bacterial peritonitis in patients with cirrhosis
Author(s) -
Kim Jung Hee,
Lim Kyung Sook,
Min Yang Won,
Lee Hyuk,
Min ByungHoon,
Rhee PoongLyul,
Kim Jae J,
Koh Kwang Cheol,
Paik Seung Woon
Publication year - 2017
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13637
Subject(s) - spontaneous bacterial peritonitis , medicine , propensity score matching , hazard ratio , incidence (geometry) , gastroenterology , confidence interval , retrospective cohort study , cohort , cirrhosis , ascites , proton pump inhibitor , cohort study , sepsis , population , risk factor , physics , environmental health , optics
Background and Aim The present study aimed to assess the real impact of proton pump inhibitor (PPI) use on incidence of recurrent spontaneous bacterial peritonitis (SBP) in a homogenous population composed of cirrhotic patients with a previous SBP where differences related with SBP incidence between PPI users and non‐users are less likely to exist. Methods This retrospective cohort study enrolled 307 cirrhotic patients taking diuretics for ascites control and had a previous SBP. Patients who took any PPI for at least 1 week prior to a second SBP were included in the PPI group. The incidence of a second SBP was a primary outcome and was compared between PPI group and non‐PPI group before and after propensity score matching. Risk factors for a second SBP were investigated by multivariate analysis. Results Second SBP occurred in 17 patients (29.3%) during mean 52.1 ± 5.2 months of PPI group and in 60 patients (24.1%) during mean 61.9 ± 4.8 months of non‐PPI group, which did not differ ( P = .185). In the matched cohort, second SBP similarly occurred in both groups [29.3% of PPI group vs 26.8% of non‐PPI group ( P = .271)]. According to the multivariate analysis, Child–Pugh score was the only significant risk factor for a second SBP (hazard ratio 1.68, 95% confidence interval, 1.13–2.50, P = .001). Isolated bacteria and clinical outcomes such as of mortality, presence of sepsis, and hospital stay did not differ between the two groups in the matched cohort. Conclusion Proton pump inhibitor use is not a risk factor for recurrent SBP in cirrhotic patients.