Is the Use of Proton Pump Inhibitors a Predisposing Factor for Pyogenic Liver Abscesses?

Area of Science:

• Gastroenterology
• Hepatology
• Infectious Diseases

Background:

• Proton pump inhibitors (PPIs) reduce stomach acid, increasing gastric pH.
• Elevated gastric pH may promote bacterial translocation.
• The link between PPI use and pyogenic liver abscesses requires investigation.

Purpose of the Study:

• To determine if there is a correlation between proton pump inhibitor use and the development of pyogenic liver abscesses.

Main Methods:

• Retrospective case-control analysis of adult patients diagnosed with liver abscess between 2015-2019.
• Exclusion criteria included prior liver abscess, biliary disease, malignancy, or intra-abdominal infections.
• Multivariate logistic regression analysis adjusted for confounding factors.

Main Results:

• Proton pump inhibitor use was associated with an increased risk of first-episode pyogenic liver abscess.
• Univariate analysis showed an odds ratio (OR) of 2.36 (95% CI: 1.70-3.27).
• Multivariate analysis confirmed this association with an adjusted OR of 2.27 (95% CI: 1.55-3.32).

Conclusions:

• This US population-based study is the first to demonstrate an association between PPI use and pyogenic liver abscess risk.
• Further prospective research is necessary to elucidate the dose-response and duration-response relationship.
• The findings suggest a potential adverse effect of PPIs on liver health.