NPR logo Heartburn Drugs Boost Hospital Pneumonias?

Heartburn Drugs Boost Hospital Pneumonias?

It's often been said that hospitals are the worse place in the world for sick people because of the infections that can be picked up there.

NPR's Joanne Silberner reports on All Things Considered today that some researchers think they are seeing a correlation between the widespread practice of giving hospitalized patients heartburn drugs and many of those patients later developing pneumonia.

Here's an excerpt from her report:

SILBERNER:Last year $14 billion worth of proton-pump inhibitors were prescribed in the U.S., according to health-care information company IMS Health. About half of all hospitalized patients get a drug like Nexium or Prilosec or Prevacid to suppress acid production in the stomach.

Shoshana Herzig of Beth Israel Deaconness Medical Center in Boston wasn't sure that's such a good idea. Several studies of non-hospitalized patients suggest that the drugs increase the risk of pneumonia, possibly by dampening the immune system, or allowing bacteria from the stomach to infect the lungs.

So she and several colleagues looked at the charts of 64,000 patients admitted to her hospital.

HERZIG: We found that patients who were exposed to these medications during their hospitalization had a higher rate of hospital acquired pneumonia. It was a 30 percent increased odds.

SILBERNER: Another way to think of it — the drugs could cause one extra case of pneumonia among every 111 hospitalized patients who get them.

HERZIG: It sounds like a small number. But when you take into account the fact that 50 percent, some studies estimate that up to 70 percent of hospitalized patients are exposed to these medications, it actually becomes a very large number of patients who are at risk..."

Silberner goes on to report that while the retrospective study is suggestive, it's not conclusive. She also says manufacturers of the heartburn drugs declined to comment on the study, published in the Journal of the American Medical Association, until they reviewed it.

There is growing consensus in the medical community that these proton-pump inhibitors are being greatly overprescribed by physicians in developed countries.

An editorial in the British Medical Journal last year said that between 25 percent and 70 percent of British patients apparently shouldn't be taking the medications at all, a huge problem for a number of reasons, including the much higher costs of these drugs compared to alternatives.