Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
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.
Sataloff RT. Community-Acquired Pneumonia and Use of Gastric Acid–Suppressive Drugs. JAMA. 2005;293(7):795-796. doi:10.1001/jama.293.7.795-c