Acid suppression therapy and its association with spontaneous bacterial peritonitis incidence: A systemic review and meta‐analysis

2019 ◽  
Vol 50 (2) ◽  
pp. 233-245
Author(s):  
Lin Lin ◽  
Lijun Hou ◽  
You Deng ◽  
Tianming Zhao ◽  
Bangmao Wang ◽  
...  
Keyword(s):  
Spontaneous Bacterial Peritonitis ◽  
Meta Analysis ◽  
Acid Suppression ◽  
Systemic Review ◽  
Bacterial Peritonitis ◽  
Acid Suppression Therapy

Proton Pump Inhibitor Use and Association with Spontaneous Bacterial Peritonitis in Patients with Cirrhosis and Ascites

2012 ◽  
Vol 46 (10) ◽  
pp. 1413-1418 ◽  
Author(s):  
Jolene F Siple ◽  
Jessica M Morey ◽  
Tracy E Gutman ◽  
Kathy L Weinberg ◽  
Peggie D Collins
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Spontaneous Bacterial Peritonitis ◽  
Meta Analysis ◽  
Gastrointestinal Symptoms ◽  
Case Series ◽  
Acid Suppression ◽  
Data Sources ◽  
Bacterial Peritonitis ◽  
Increased Risk

Objective: To evaluate the literature regarding the efficacy and safety of proton pump inhibitors (PPIs) when they are used in patients with cirrhosis and ascites. Data Sources: A literature search was conducted using MEDLINE (1966-May 2012) and Web of Science (1990-May 2012) with the terms proton pump inhibitor, antisecretory therapy, cirrhosis, ascites, spontaneous bacterial peritonitis, and Clostridium difficile. The search was restricted to articles published in English on the use of PPIs in humans. Reference citations from identified published articles were reviewed for relevant information. Study Selection and Data Extraction: All articles in English identified from the data sources were evaluated for inclusion. One case series, 8 retrospective case-control trials, and 1 meta-analysis were identified. Data Synthesis: Cirrhosis may cause complications such as portal hypertension, esophageal varices, and ascites. Patients may be prescribed PPIs without clear indications or because of their propensity to develop upper gastrointestinal symptoms and bleeding. However, gastric acidity is a major nonspecific defense mechanism and there is insufficient evidence on the need for chronic acid suppression in patients with cirrhosis. It is postulated that the portal hypertensive environment in cirrhosis and the acid suppression from PPIs can increase the risk of spontaneous bacterial peritonitis and C. difficile infection in patients with cirrhosis with ascites. Several retrospective studies and 1 meta-analysis have confirmed this association. Conclusions: Patients with cirrhosis and ascites should be monitored carefully while on PPIs for a possible increased risk of infection from spontaneous bacterial peritonitis and C. difficile. Prospective randomized trials are needed to confirm this association. Clinicians should be aware of this lesser known adverse effect of PPIs.

scholarly journals Ascitic calprotectin and lactoferrin for detection of spontaneous bacterial peritonitis: a systemic review and meta-analysis

2021 ◽  
Vol 0 ◽  
pp. 0-0
Author(s):  
Kishan P. Patel ◽  
Parker M. Korbitz ◽  
John P. Gallagher ◽  
Cynthia Schmidt ◽  
Thammasin Ingviya ◽  
...  
Keyword(s):  
Spontaneous Bacterial Peritonitis ◽  
Meta Analysis ◽  
Systemic Review ◽  
Bacterial Peritonitis
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