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Proton pump inhibitor use significantly increases the risk of cryptogenic liver abscess: a population-based study

Y-P Wang1, C-J Liu, T-J Chen

  • 1Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.

Alimentary Pharmacology & Therapeutics
|April 15, 2015
PubMed
Abstract

Insights

Proton pump inhibitor use increases the risk of liver abscess. This study found a significant association between proton pump inhibitor therapy and cryptogenic liver abscess development.

Area of Science:

  • Gastroenterology
  • Hepatology
  • Infectious Diseases

Background:

  • Proton pump inhibitors (PPIs) elevate gastric pH, potentially compromising defenses against ingested pathogens.
  • This mechanism may facilitate the intestinal overgrowth of virulent Klebsiella pneumoniae, leading to liver abscess.

Purpose of the Study:

  • To investigate the association between proton pump inhibitor (PPI) use and cryptogenic liver abscess in Taiwan.
  • To quantify the risk of liver abscess associated with PPIs.

Main Methods:

  • A population-based case-control study was conducted using Taiwan's National Health Insurance Research Database.
  • Data from 958 adult liver abscess cases and 3832 matched controls (2000-2010) were analyzed.
  • Conditional logistic regression estimated adjusted odds ratios (ORs) for PPI use prior to liver abscess.

Main Results:

  • Current PPI use (within 30 days) showed an adjusted OR of 4.7 for cryptogenic liver abscess.
  • Recent PPI use (within 31-90 days) had an adjusted OR of 2.9.
  • A dose-response relationship was observed, with PPIs exceeding 60 cumulative defined daily doses showing the highest OR (6.5).

Conclusions:

  • Proton pump inhibitor therapy within the 90 days preceding the study period was significantly associated with an increased risk of cryptogenic liver abscess.
  • These findings highlight a potential iatrogenic risk associated with PPI use.

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