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Drugs That Suppress Gastric Acid Linked to Risk of Resistant Organisms

MedicalResearch.com Interview with:
Drs. R.P.J. Willems  |  Arts-onderzoeker
Medische Microbiologie en Infectiepreventie
Amsterdam

MedicalResearch.com: What is the background for this study? Does your study refer to both PPIs and H2-blockers?

 Response: There is mixed evidence on the associated risk of colonization and infection with multidrug-resistant microorganisms with acid suppressive therapy.

We therefore aimed to investigate current literature in order to determine whether acid suppressants facilitate intestinal colonization with multidrug-resistant microorganisms. We included studies on PPIs, H2 blockers and antacids.

MedicalResearch.com: What are the main findings?

Response: We found that the use of acid suppressants (mainly the use of PPIs and H2 blockers) increases the risk of intestinal colonization with multidrug-resistant microorganisms (Enterobacteriaceae producing extended-spectrum β-lactamases, carbapenemases, or AmpC β-lactamases and vancomycin-resistant enterococci). Nevertheless, our findings should be interpreted with caution, given the observational nature of the studies. 

MedicalResearch.com: What should readers take away from your report?

Response: Since their market introduction in the late 1980s, PPI use has become widespread. On top of that, PPIs are freely available at drugstores and indications for use are often inappropriate. In view of the global problem of antimicrobial resistance, and the facilitating effect that PPIs appear to have on colonization with these multidrug-resistant microorganisms, we hope that physicians will realize that by being critical when prescribing PPIs, they help in preventing the spread of resistant strains.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Future research should address interventions that promote rational use of PPIs, and thus focus on evaluating whether the risks of MDRO colonization and infection are reduced after discontinuation of unnecessary acid suppressive therapy.

I have no conflicts of interest.

Citation:

Willems RPJ, van Dijk K, Ket JCF, Vandenbroucke-Grauls CMJE. Evaluation of the Association Between Gastric Acid Suppression and Risk of Intestinal Colonization With Multidrug-Resistant MicroorganismsA Systematic Review and Meta-analysisJAMA Intern Med. Published online February 24, 2020. doi:10.1001/jamainternmed.2020.0009

 

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Feb 25, 2020 @ 1:27 pm

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