Association between pulmonary and digestive infections in patients receiving gastric acid-lowering medications for a long duration

Objectives: To evaluate the frequency of pulmonary and digestive infections in a population of disabilitated patients receiving gastric acid-lowering medications for a long duration. Methods: Cases underwent gastric acid-lowering medications for at least 4 years and controls were matched on type of handicap, aetiologies of handicap, sex and age and didn't receive gastric acid-lowering medications. For each patient, the following data were collected: age, sex, aetiology of disabilitation, type of gastric acid-lowering medications ( histamine receptor H2 antagonists or proton pump inhibitors), occurrence of gastric or oesophageal pathology, nasogastric tube or gastrostomy device, motor handicap, number of digestive infections and number of pulmonary infections during the last 5 years. Results: Total rate of infections was significantly more frequent in patients receiving gastric acid lowering medications than in patients who did not receive gastric acid-lowering medications (p = 0.035). Pulmonary infections were significantly more frequent in patients receiving gastric acid-lowering medications than in those who did not receive gastric acid-lowering medications (p < 0.05). The rate of digestive infections was not influenced by acid-suppressive treatments. Conclusion: Oesophagitis may lead to complications and requires gastric acid-lowering medications; in fact these drugs promote bacterial development and subsequently increase the risk of pulmonary infections.