ArticleJAMA2004
Risk of community-acquired pneumonia and use of gastric acid-suppressive drugs.
Article in JAMA, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01524757 (Proton Pump Inhibitors in the Prevention of Iron Reaccumulation in Patient With Hereditary Hemochromatosis), which is not on this map. Cited by 246 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Proton Pump Inhibitors in the Prevention of Iron Reaccumulation in Patient With Hereditary Hemochromatosis
Who cites it
246 citing papers in PubMed, 7 syntheses or guidelines pooled it, 875 citations in OpenAlex.
- Proton pump inhibitors for chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2020Pooled it
- Guideline
- Risk of community-acquired pneumonia with outpatient proton-pump inhibitor therapy: a systematic review and meta-analysis.PloS one · 2015Pooled it
- Long-term proton pump inhibitor (PPI) use and the development of gastric pre-malignant lesions.The Cochrane database of systematic reviews · 2014Pooled it
- Pooled it
- Use of acid-suppressive drugs and risk of pneumonia: a systematic review and meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2011Pooled it
- Gastro-oesophageal reflux treatment for prolonged non-specific cough in children and adults.The Cochrane database of systematic reviews · 2011Pooled it
- Lansoprazole for persistent throat symptoms in secondary care: the TOPPITS RCT.Health technology assessment (Winchester, England) · 2021Trial
- Randomised, double-blind, placebo-controlled pilot trial of omeprazole in idiopathic pulmonary fibrosis.Thorax · 2019Trial
- Effectiveness of a Multifaceted Intervention for Potentially Inappropriate Prescribing in Older Patients in Primary Care: A Cluster-Randomized Controlled Trial (OPTI-SCRIPT Study).Annals of family medicine · 2015Trial
- Lansoprazole Is Associated with Worsening Asthma Control in Children with the CYP2C19 Poor Metabolizer Phenotype.Annals of the American Thoracic Society · 2015Trial
- Evaluation of electrolyte repletion in hematopoietic cell transplant patients receiving H-2 receptor antagonists or proton pump inhibitors.Bone marrow transplantation · 2014Trial
- Association of CYP2C19 polymorphisms and lansoprazole-associated respiratory adverse effects in children.The Journal of pediatrics · 2013Trial
- An automated tool for detecting medication overuse based on the electronic health records.Pharmacoepidemiology and drug safety · 2013Trial
- Gaviscon® vs. omeprazole in symptomatic treatment of moderate gastroesophageal reflux. a direct comparative randomised trial.BMC gastroenterology · 2012Trial
- Trial
- Peritonitis and Mortality Risks of Gastric Acid Suppressants in Patients Undergoing Peritoneal Dialysis.Kidney international reports · 2026Article
- Rethinking proton pump inhibitor deprescribing: from tapering strategies to patient-centered management.Journal of gastroenterology · 2026Article
- Article
- The microbiome research in obstetrics and gynecology is getting attention-Some reasons why.Acta obstetricia et gynecologica Scandinavica · 2026Article
186 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextReduction of gastric acid secretion by acid-suppressive therapy allows pathogen colonization from the upper gastrointestinal tract. The bacteria and viruses in the contaminated stomach have been identified as species from the oral cavity.
objectiveTo examine the association between the use of acid-suppressive drugs and occurrence of community-acquired pneumonia. DESIGN, SETTING, AND
participantsIncident acid-suppressive drug users with at least 1 year of valid database history were identified from the Integrated Primary Care Information database between January 1, 1995, and December 31, 2002. Incidence rates for pneumonia were calculated for unexposed and exposed individuals. To reduce confounding by indication, a case-control analysis was conducted nested in a cohort of incident users of acid-suppressive drugs. Cases were all individuals with incident pneumonia during or after stopping use of acid-suppressive drugs. Up to 10 controls were matched to each case for practice, year of birth, sex, and index date. Conditional logistic regression was used to compare the risk of community-acquired pneumonia between use of proton pump inhibitors (PPIs) and H2-receptor antagonists.
main outcome measureCommunity-acquired pneumonia defined as certain (proven by radiography or sputum culture) or probable (clinical symptoms consistent with pneumonia).
resultsThe study population comprised 364,683 individuals who developed 5551 first occurrences of pneumonia during follow-up. The incidence rates of pneumonia in non-acid-suppressive drug users and acid-suppressive drug users were 0.6 and 2.45 per 100 person-years, respectively. The adjusted relative risk for pneumonia among persons currently using PPIs compared with those who stopped using PPIs was 1.89 (95% confidence interval, 1.36-2.62). Current users of H2-receptor antagonists had a 1.63-fold increased risk of pneumonia (95% confidence interval, 1.07-2.48) compared with those who stopped use. For current PPI users, a significant positive dose-response relationship was observed. For H2-receptor antagonist users, the variation in dose was restricted.
conclusionCurrent use of gastric acid-suppressive therapy was associated with an increased risk of community-acquired pneumonia.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.