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Peritonsillar abscess, deep neck infection, and proton pump inhibitor: A nested case-control study
Young Ju Jin1, Woo-Hyun Nam1, Hyo Geun Choi2
1Department of Otorhinolaryngology-Head and Neck Surgery, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, South Korea.
Auris, Nasus, Larynx
|June 4, 2026
Summary
Proton pump inhibitor (PPI) use is linked to a higher risk of peritonsillar abscess (PTA) and deep neck infection (DNI). Prolonged PPI use showed a stronger association with these infections.
Area of Science:
- Gastroenterology
- Otolaryngology
- Infectious Diseases
Background:
- Proton pump inhibitors (PPIs) are widely used for acid-related gastrointestinal disorders.
- The potential extra-esophageal effects of PPIs, including infection risks, require further investigation.
Purpose of the Study:
- To examine the association between proton pump inhibitor (PPI) use and the risk of developing peritonsillar abscess (PTA) and deep neck infection (DNI).
Main Methods:
- A nested case-control study using Korean National Health Insurance Service data (2002-2013).
- 1953 PTA and 5797 DNI cases were matched with controls.
- PPI exposure was assessed based on timing and duration, with analysis using overlap propensity score weighting.
Main Results:
- Current PPI use significantly increased the risk of PTA (aOR 2.83) and DNI (aOR 2.80).
- Past PPI users also showed increased odds for DNI (aOR 1.85).
- A dose-dependent relationship was observed, with longer PPI use correlating with higher infection risks (p < 0.001).
Conclusions:
- PPI use is associated with elevated odds of PTA and DNI, especially with current and prolonged use.
- Clinicians should consider the potential infection risks associated with long-term PPI prescriptions.
- The study highlights an association, not a causal link, due to its observational nature.
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