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February 16, 2005

Community-Acquired Pneumonia and Use of Gastric Acid–Suppressive Drugs

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;293(7):795-796. doi:10.1001/jama.293.7.795-c

To the Editor: I believe that the study of community-acquired pneumonia and gastric acid–suppressive drugs by Dr Laheij and colleagues1 did not use an appropriate control group. Ideally, a study population taking proton pump inhibitors should have been compared with a population of untreated patients with gastroesophageal reflux of similar severity to determine whether the episodes of pneumonia were caused by reflux, or caused by effects of the proton pump inhibitors. Reflux is associated with airway problems, including laryngopharyngitis, uncontrolled asthma, bronchitis, and pneumonia.2 The reflux status of their control group is not known and it included patients who had stopped taking proton pump inhibitors; this may have been a population of patients who did not actually have reflux and who stopped their medications because they were not helpful.

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