SynthesisCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2011
Use of acid-suppressive drugs and risk of pneumonia: a systematic review and meta-analysis.
Synthesis in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 144 papers, 12 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
144 citing papers in PubMed, 12 syntheses or guidelines pooled it, 395 citations in OpenAlex.
- Proton pump inhibitor on susceptibility to COVID-19 and its severity: a systematic review and meta-analysis.Pharmacological reports : PR · 2021Pooled it
- Reducing Inappropriate Proton Pump Inhibitors Use for Stress Ulcer Prophylaxis in Hospitalized Patients: Systematic Review of De-Implementation Studies.Journal of general internal medicine · 2021Pooled it
- Head of bed elevation to relieve gastroesophageal reflux symptoms: a systematic review.BMC family practice · 2021Pooled it
- Proton pump inhibitors for chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2020Pooled it
- Associations of Proton-Pump Inhibitors and H2 Receptor Antagonists with Chronic Kidney Disease: A Meta-Analysis.Digestive diseases and sciences · 2017Pooled it
- Acupuncture and related therapies used as add-on or alternative to prokinetics for functional dyspepsia: overview of systematic reviews and network meta-analysis.Scientific reports · 2017Pooled it
- Guideline
- Risk of community-acquired pneumonia with outpatient proton-pump inhibitor therapy: a systematic review and meta-analysis.PloS one · 2015Pooled it
- Evidence-based assessment of proton-pump inhibitors in Helicobacter pylori eradication: a systematic review.World journal of gastroenterology · 2014Pooled it
- Pooled it
- Risk of pneumonia associated with use of angiotensin converting enzyme inhibitors and angiotensin receptor blockers: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2012Pooled it
- Is routine stress ulcer prophylaxis of benefit for patients undergoing cardiac surgery?Interactive cardiovascular and thoracic surgery · 2012Pooled it
- Randomised, double-blind, placebo-controlled pilot trial of omeprazole in idiopathic pulmonary fibrosis.Thorax · 2019Trial
- Proton pump inhibitors and hospitalization with hypomagnesemia: a population-based case-control study.PLoS medicine · 2014Trial
- Anti-acid treatment and disease progression in idiopathic pulmonary fibrosis: an analysis of data from three randomised controlled trials.The Lancet. Respiratory medicine · 2013Trial
- Safety and efficacy of long-term esomeprazole 20 mg in Japanese patients with a history of peptic ulcer receiving daily non-steroidal anti-inflammatory drugs.BMC gastroenterology · 2013Trial
- Trial
- The microbiome research in obstetrics and gynecology is getting attention-Some reasons why.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Impact of proton pump inhibitor use on immune-related adverse events in patients with non-small cell lung cancer: a retrospective study.BMC cancer · 2026Article
- Unveiling the intricacies: Insight into gastroesophageal reflux disease.World journal of gastroenterology · 2025Review
84 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundObservational studies and randomized controlled trials have yielded inconsistent findings about the association between the use of acid-suppressive drugs and the risk of pneumonia. We performed a systematic review and meta-analysis to summarize this association.
methodsWe searched three electronic databases (MEDLINE [PubMed], Embase and the Cochrane Library) from inception to Aug. 28, 2009. Two evaluators independently extracted data. Because of heterogeneity, we used random-effects meta-analysis to obtain pooled estimates of effect.
resultsWe identified 31 studies: five case-control studies, three cohort studies and 23 randomized controlled trials. A meta-analysis of the eight observational studies showed that the overall risk of pneumonia was higher among people using proton pump inhibitors (adjusted odds ratio [OR] 1.27, 95% confidence interval [CI] 1.11-1.46, I(2) 90.5%) and histamine(2) receptor antagonists (adjusted OR 1.22, 95% CI 1.09-1.36, I(2) 0.0%). In the randomized controlled trials, use of histamine(2) receptor antagonists was associated with an elevated risk of hospital-acquired pneumonia (relative risk 1.22, 95% CI 1.01-1.48, I(2) 30.6%).
interpretationUse of a proton pump inhibitor or histamine(2) receptor antagonist may be associated with an increased risk of both community- and hospital-acquired pneumonia. Given these potential adverse effects, clinicians should use caution in prescribing acid-suppressive drugs for patients at risk.
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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.