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October 7, 2009

Acid-Suppressive Medication and Hospital-Acquired Pneumonia

JAMA. 2009;302(13):1415-1417. doi:10.1001/jama.2009.1415

To the Editor: Acid suppression therapy is associated with an increased risk of community-acquired pneumonia, and Dr Herzig and colleagues1 reported that these drugs also increase the odds of HAP by 30%. Unlike community-acquired pneumonia, this association was only apparent with proton-pump inhibitors, although it was acknowledged that the study might have been underpowered to detect a smaller effect with histamine2 receptor antagonists. Two mechanisms were suggested for the increase in pneumonia: gastric overgrowth and aspiration of bacteria, and impaired leukocyte function.