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PPI use increased risk for nontyphoid salmonellosis
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Recent use of proton pump inhibitors was associated with nontyphoid salmonellosis, according to researchers with the CDC in Taiwan.
“We found a temporal association between use of [proton pump inhibitors] and increased susceptibility to [nontyphoid salmonellosis] after matching for predisposing factors,” the researchers wrote in Clinical Infectious Diseases. “Health care providers should consider the increased risk of potential [nontyphoid salmonellosis] within 30 days after the prescription discontinued.”
The researchers conducted a nested case-control study in hospitalized patients. They identified 14,736 cases of nontyphoid salmonellosis by searching the Taiwan National Health Insurance Research Database from 2000 to 2010, and included four well-matched controls for each case (n=58,944).
They found an association between any proton pump inhibitor (PPI) use and nontyphoid salmonellosis (adjusted OR=2.09; 95% CI, 1.95-2.24). After adjustment, current PPI use was associated with the highest risk (adjusted OR=5.39; 95% CI, 4.79-6.06), but increased risk was also seen for PPI use within the past 1 to 7 days (adjusted OR=4.2; 95% CI, 3.21-5.48) and use within the past 8 to 30 days (adjusted OR=1.9; 95% CI, 1.55-2.33).
There was also an association between nontyphoidal salmonellosis and the recent use of nonsteroidal anti-inflammatory drugs (adjusted OR=2.37; 95% CI, 2.26-2.48), H2-receptor antagonists (adjusted OR=1.84; 95% CI, 1.71-1.98), steroids (adjusted OR=3.18; 95% CI, 2.99-3.39) and antibiotics (adjusted OR=5.21; 95% CI, 4.81-5.64). The link between PPI use and nontyphoidal salmonellosis was still significant in subgroups not receiving these medications.
“This study provides further evidence that PPI use is associated with an increased risk of [nontyphoidal salmonellosis] after matching for well-known predisposing factors,” the researchers wrote. “The risk of acquisition of [nontyphoidal salmonellosis] was highest among current users, and waned with time after use of PPIs.”
Disclosure: The researchers report no relevant financial disclosures.
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