scholarly journals Increased Risk of Spontaneous Bacterial Peritonitis in Cirrhotic Patients Using Proton Pump Inhibitors

2018 ◽  
Vol 26 (2) ◽  
pp. 83-89 ◽  
Author(s):  
Abdel-Naser Elzouki ◽  
Nadia Neffati ◽  
Fatma A. Rasoul ◽  
Ali Abdallah ◽  
Muftah Othman ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Spontaneous Bacterial Peritonitis ◽  
Bacterial Peritonitis ◽  
Increased Risk ◽  
Cirrhotic Patients

scholarly journals Determining the Risk of Spontaneous Bacterial Peritonitisdue to increase use of Proton Pump Inhibitors among cirrhotic patients with ascites

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Bashir Ahmed Shaikh ◽  
Zahid Ali Shaikh ◽  
Aftab Hussain Shah ◽  
Aneel Kumar
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Spontaneous Bacterial Peritonitis ◽  
Polymorphonuclear Neutrophil ◽  
Retrospective Case ◽  
Medical College ◽  
Creative Commons ◽  
Bacterial Peritonitis ◽  
History Of ◽  
Cirrhotic Patients

Objectives: The current study aimed to determine the Spontaneous Bacterial Peritonitis (SBP) risk due to increased use of Proton Pump Inhibitors (PPIs) among cirrhotic patients with ascites. Methods: This retrospective case-control study was conducted at Chandka Medical College & Hospital, Larkana from March 2013 to February 2014, involving 215 cirrhotic patients with ascites. Paracentesis was performed to distinguish cirrhotic patients with SBP and Polymorphonuclear Neutrophil (PMN) count ≥ 250 neutrophils/mm3 (cases) and non-SBP with PMN count < 250 neutrophils/mm3 (controls). The demographic details, history of PPIs use before admission and duration of Chronic Liver Disease (CLD) were inquired and statistical analysis was carried through SPSS Version 23.0. Results: Increased pre-hospital PPI intake was observed among cirrhotic patients with SBP (69.8%) as compared to those without SBP (48.8%; p = 0.014). The mean duration of PPI use was 19.16 ± 4.772 days, and it was more significant among older cirrhotic patients (p < 0.05). Increased duration of CLD was observed among PPI users, i.e. 20.47 ± 6.305 months vs. 18.95 ± 5.527 months among non-PPI users (p < 0.05). Conclusions: Our results show that cirrhotic patients with ascites consuming PPIs are more likely to develop SBP as compared to non-PPI users. doi: https://doi.org/10.12669/pjms.37.4.3476 How to cite this:Shaikh BA, Shaikh ZA, Shah AH, Kumar A. Determining the Risk of Spontaneous Bacterial Peritonitis due to increase use of Proton Pump Inhibitors among cirrhotic patients with ascites. Pak J Med Sci. 2021;37(4):---------.   doi: https://doi.org/10.12669/pjms.37.4.3476 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Role of proton pump inhibitors in the occurrence and the prognosis of spontaneous bacterial peritonitis in cirrhotic patients with ascites

2013 ◽  
Vol 33 (9) ◽  
pp. 1316-1323 ◽  
Author(s):  
Marie de Vos ◽  
Bénédicte De Vroey ◽  
Béatrice Garcia Garcia ◽  
Clothilde Roy ◽  
François Kidd ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Spontaneous Bacterial Peritonitis ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients

scholarly journals Association Between Proton Pump Inhibitor Use and Spontaneous Bacterial Peritonitis in Cirrhotic Patients with Ascites

2014 ◽  
Vol 28 (6) ◽  
pp. 330-334 ◽  
Author(s):  
Mélissa Ratelle ◽  
Sylvie Perreault ◽  
Jean-Pierre Villeneuve ◽  
Lydjie Tremblay
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Spontaneous Bacterial Peritonitis ◽  
Inclusion Criteria ◽  
Retrospective Case ◽  
Bacterial Peritonitis ◽  
Increased Risk ◽  
Pugh Class ◽  
Cirrhotic Patients ◽  
Control Study

BACKGROUND: There are data suggesting a link between proton pump inhibitor (PPI) use and the development of spontaneous bacterial peritonitis (SBP) in cirrhotic patients with ascites; however, these data are controversial.OBJECTIVE: To assess whether the use of PPIs in cirrhotic patients with ascites is associated with an increased risk for SBP.METHODS: A retrospective case-control study (June 2004 to June 2010) was conducted at theCentre Hospitalier de l’Université de Montréalin Montreal, Quebec. Fifty-one cirrhotic patients admitted with paracentesis-proven SBP (≥250 neutrophils/mm3), occurring within seven days of hospital admission, met the inclusion criteria. These patients were matched 1:2 (for age, Child-Pugh class and year of admission) with 102 comparable cirrhotic patients with ascites who were admitted for conditions other than SBP.RESULTS: Patients with SBP had a significantly higher rate of pre-hospital PPI use (60.8%) compared with cirrhotic patients without SBP (42.2%; P=0.03). On multivariate analysis, PPI use was the only factor independently associated with SBP (OR 2.09 [95% CI 1.04 to 4.23]; P=0.04). Thirty-five (35%) patients in both groups had no documented indication for PPI use in their charts. Forty-five percent of the remaining cirrhotic patients with SBP had an inappropriate indication, as defined in the protocol, for PPI use compared with 25% of controls.CONCLUSIONS: Cirrhotic patients with SBP were twice as likely to have taken PPIs than patients without SBP. These findings reinforce the association between PPI use and SBP observed in other studies. A high percentage of cirrhotic patients were taking a PPI without any documented indication.

scholarly journals The association between pre hospital use of proton pump inhibitors and spontaneous bacterial peritonitis in patients presenting with liver cirrhosis.

2019 ◽  
Vol 26 (11) ◽  
pp. 2003-2008
Author(s):  
Muhammad Hussain Baloch ◽  
Riaz Hussain Awan ◽  
Seema Nayab ◽  
Khadim Hussain Awan ◽  
Faqir Muhammad Awan
Keyword(s):  
Liver Cirrhosis ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Spontaneous Bacterial Peritonitis ◽  
Operational Definition ◽  
Endoscopic Variceal Ligation ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients ◽  
Control Study ◽  
Hospital Use

Objectives: To determine the association between pre hospital use of proton pump inhibitors and spontaneous bacterial peritonitis in patients presenting with liver cirrhosis. Study Design: Case control study.  Setting: Department of Gastroenterology at Liaquat National Hospital Karachi. Period: Six months (From 1st – March-2017 to 31st – August-2017). Material and Methods: There were 120 patients with cirrhosis were included in this study. Sixty patients were cases with spontaneous bacterial peritonitis (SBP) and 60 patients were control without spontaneous bacterial peritonitis. All patients were interviewed for pre hospital intake of PPI (as per operational definition). All the data was entered on predesigned proforma (attached). Results: The average age of the patients was 42.47±9.87 years. Rate of PPI use was significantly higher among cases with SBP (46.7%) as compared to the patients without SBP (23.3%). Conclusion: In conclusion, PPI use (acid suppression) was associated with the development of SBP in cirrhotic patients with ascites.  We recommend that PPI indications in cirrhotic patients should be frequently re-evaluated with particular attention devoted to duration of use, especially following endoscopic variceal ligation (EVL).

Mortality associated with proton pump inhibitors in cirrhotic patients with spontaneous bacterial peritonitis

2014 ◽  
Vol 29 (4) ◽  
pp. 775-781 ◽  
Author(s):  
Jee Hye Kwon ◽  
Seong-Joon Koh ◽  
Won Kim ◽  
Yong Jin Jung ◽  
Ji Won Kim ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Spontaneous Bacterial Peritonitis ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients

scholarly journals Proton pump inhibitors use and risk of developing spontaneous bacterial peritonitis in cirrhotic patients: A systematic review and meta-analysis

Gut Pathogens ◽  
2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Saad Alhumaid ◽  
Abbas Al Mutair ◽  
Zainab Al Alawi ◽  
Abdul Rehman Zia Zaidi ◽  
Ali A. Rabaan ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Spontaneous Bacterial Peritonitis ◽  
Meta Analysis ◽  
Case Control ◽  
Quality Data ◽  
Proton Pumps ◽  
Case Control Studies ◽  
Bacterial Peritonitis ◽  
Cirrhotic Patients

Abstract Background Spontaneous bacterial peritonitis (SBP) is one of the most common infectious diseases in patients with cirrhosis and is associated with serious prognosis. A prevailing dogma posits that SBP is exacerbated by the frequent use of proton pump inhibitors (PPIs). Aims To re-assess the association between PPIs use and SBP incidence with larger and better-quality data. Method The studies were identified by searching Proquest, Medline, and Embase for English language articles published between January 2008 and March 2020 using the following keywords alone or in combination: anti-ulcer agent, antacid, proton pump inhibitor, proton pumps, PPI, omeprazole, rabeprazole, lansoprazole, pantoprazole, esomeprazole, peritonitis, spontaneous bacterial peritonitis, SBP, ascites, cirrhosis, ascitic and cirrhotic. Three authors critically reviewed all of the studies retrieved and selected those judged to be the most relevant. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Sub-group analyses were done to decrease the heterogeneity. Results A total of twenty-three studies: seven case–control, and sixteen cohorts, involving 10,386 patients were analyzed. The overall results showed a statistically significant association between SBP and PPIs use (pooled odds ratio (OR): 1.80, 95% CI of 1.41 to 2.31). Substantial heterogeneity was observed. On subgroup analysis involving cohort studies, the association was weaker (OR: 1.55 with 95% CI of 1.16 to 2.06 p < 0.00001) but still statistically significant and with high heterogeneity (Chi2p = 57.68; I2 = 74%). For case–control studies, the OR was 2.62 with a 95% CI of 1.94 to 3.54. The funnel plot was asymmetric and Egger’s test confirmed asymmetry suggesting publication bias (intercept = − 0.05, SE = 0.27, P = 0.850 two-tailed). Conclusion This meta-analysis sheds light on the conflicting results raised by previous studies regarding the association of SBP with PPIs use. Our meta-analysis showed that there is a weak association, although statistically significant, between SBP and PPIs use. However, the magnitude of the possible association diminished when analysis focused on higher quality data that were more robust. Thus, this updated meta-analysis suggests judicious use of PPIs among cirrhotic patients with ascites.

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