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Use of proton pump inhibitors and cholangitis complicated with multi-drug resistant bacteria

Ryunosuke Hakuta1,2, Yousuke Nakai1,2, Tsuyoshi Hamada1

  • 1Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Journal of Hepato-Biliary-Pancreatic Sciences
|August 12, 2021
PubMed
Abstract

Insights

Regular use of proton pump inhibitors (PPIs) is linked to a higher incidence of cholangitis caused by multidrug-resistant bacteria (MDRB). This study highlights a potential risk associated with common acid-reducing medications.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Pharmacology

Background:

  • Multidrug-resistant bacteria (MDRB) pose a significant global health threat.
  • Proton pump inhibitors (PPIs) are widely used medications.
  • Emerging evidence suggests a potential link between PPI use and increased risk of MDRB infections.

Purpose of the Study:

  • To investigate the association between regular proton pump inhibitor (PPI) use and the incidence of cholangitis caused by multidrug-resistant bacteria (MDRB).
  • To compare MDRB-cholangitis rates in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) based on PPI usage.

Main Methods:

  • Retrospective analysis of patients undergoing ERCP between January 2010 and August 2019.
  • Comparison of MDRB-cholangitis incidence between regular and non-regular PPI users.
  • Statistical analysis including multivariable adjustment to assess the association.

Main Results:

  • The study included 1224 regular PPI users and 1528 non-regular PPI users.
  • The incidence of MDRB-cholangitis was significantly higher in regular PPI users (3.0%) compared to non-regular users (1.1%; P < .001).
  • Regular PPI use was associated with a multivariable-adjusted odds ratio of 2.19 for MDRB-cholangitis (P = .01).

Conclusions:

  • Regular proton pump inhibitor (PPI) use is significantly associated with an increased risk of developing cholangitis due to multidrug-resistant bacteria (MDRB).
  • Findings suggest a need for careful consideration of PPI use in patients at risk for or with a history of MDRB infections.
Keywords:
cholangitisdrug resistanceendoscopic retrograde cholangiopancreatographyproton pump inhibitors

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