Abstract
BackgroundThe relationship between proton pump inhibitor therapy and other acid suppressing medications and the risk of gastrointestinal infections remains controversial.MethodsPatients enrolled in a long-term trial of lansoprazole for Zollinger-Ellison syndrome and other acid hypersecretory states had interval histories taken every six months regarding hospitalizations or other intercurrent medical conditions. All medications taken were also reviewed at each visit. In addition, available patients were specifically queried during the study period 2006–2007 regarding the development of any gastrointestinal infections, hospitalizations, and prescriptions for antibiotics.ResultsNinety patients were enrolled in our long-term study and 81 were available for review. The median basal gastric pH for the cohort after stabilization on therapy was 2.9 and ranged from 1.1 – 8.4 with a median pentagastrin stimulated gastric pH of 1.60 (range 1.0 – 8.2). No patient developed a clinically significant gastrointestinal infection during the study. The median patient years of follow-up were 6.25 years.ConclusionIn a cohort of patients with gastric acid hypersecretion in whom acid secretion status was monitored on lansoprazole, all were free of significant gastrointestinal infections on long-term follow-up.Trial registrationNCT00204373
Highlights
The relationship between proton pump inhibitor therapy and other acid suppressing medications and the risk of gastrointestinal infections remains controversial
Patients undergo gastric acid analysis on a six monthly basis as well as evaluation for intercurrent illnesses or change in medical condition. Such a cohort provides a unique opportunity to evaluate the incidence of gastrointestinal infections and any relationship to the degree of gastric acid suppression over a prolonged period of continuous therapy
Lansoprazole doses were individually titrated in each patient to maintain basal acid output (BAO) < 5 mmol/h a benchmark based on upper limit for healthy control subjects or < 2 mmol/h post-antrectomy
Summary
The relationship between proton pump inhibitor therapy and other acid suppressing medications and the risk of gastrointestinal infections remains controversial. A cohort of patients with Zollinger-Ellison syndrome (ZES) and other hypersecretory conditions/pseudo ZES have been followed prospectively over a 18 year period as part of an ongoing study evaluating the efficacy and safety of lansoprazole therapy In this protocol, patients undergo gastric acid analysis on a six monthly basis as well as evaluation for intercurrent illnesses or change in medical condition. Patients undergo gastric acid analysis on a six monthly basis as well as evaluation for intercurrent illnesses or change in medical condition Such a cohort provides a unique opportunity to evaluate the incidence of gastrointestinal infections and any relationship to the degree of gastric acid suppression over a prolonged period of continuous therapy
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