ArticlePloS one2014
Proton pump inhibitor intake neither predisposes to spontaneous bacterial peritonitis or other infections nor increases mortality in patients with cirrhosis and ascites.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 5 of them syntheses that pooled it.
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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.
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Who cites it
29 citing papers in PubMed, 5 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Proton Pump Inhibitors Increases Longitudinal Risk of Mortality, Decompensation, and Infection in Cirrhosis: A Meta-Analysis.Digestive diseases and sciences · 2024Pooled it
- Correlation Between Proton Pump Inhibitors and the Complications of Liver Cirrhosis: A Systematic Review and Meta-Analysis.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2022Pooled it
- Proton pump inhibitor use and mortality in patients with cirrhosis: a meta-analysis of cohort studies.Bioscience reports · 2020Pooled it
- Proton pump inhibitors and risk of liver cancer and mortality in patients with chronic liver disease: a systematic review and meta-analysis.European journal of clinical pharmacology · 2020Pooled it
- Adverse outcomes of proton pump inhibitors in chronic liver disease: a systematic review and meta-analysis.Hepatology international · 2020Pooled it
- The effect of the use of proton pump inhibitors (PPI) on complications in patients with cirrhosis.BMC gastroenterology · 2026Article
- Proton Pump Inhibitor Use in Patients With Cirrhosis and Its Association With Spontaneous Bacterial Peritonitis.The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2025Article
- Proton Pump Inhibitors in Patients with Cirrhosis: Pharmacokinetics, Benefits and Drawbacks.Current gastroenterology reports · 2024Review
- [Bleeding in liver diseases].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2024Review
- Hepatic and Extrahepatic Characteristics of Autoimmune Hepatitis: A 23-year Hospital-Based Cohort Study.Digestive diseases and sciences · 2024Article
- [Optimal Use of Proton Pump Inhibitors and Potassium-competitive Acid Blockers].The Korean journal of helicobacter and upper gastrointestinal research · 2023Review
- Article
- Association Between Proton Pump Inhibitor Therapy and Spontaneous Bacterial Peritonitis Occurrence in Cirrhotic Patients: A Clinical Review.Current medical science · 2022Review
- Proton Pump Inhibitors Use and Increased Risk of Spontaneous Bacterial Peritonitis in Cirrhotic Patients: A Retrospective Cohort Analysis.Gastroenterology research · 2022Article
- Article
- Proton Pump Inhibitor Therapy Does Not Affect Prognosis of Cirrhosis Patients With Acute Decompensation and Acute-on-Chronic Liver Failure: A Single-Center Prospective Study.Frontiers in medicine · 2021Article
- The Phylogeny and Biological Function of Gastric Juice-Microbiological Consequences of Removing Gastric Acid.International journal of molecular sciences · 2019Review
- Biomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis.Scientific reports · 2019Article
- Increased Risk of Spontaneous Bacterial Peritonitis in Cirrhotic Patients Using Proton Pump Inhibitors.GE Portuguese journal of gastroenterology · 2019Article
- Safe use of proton pump inhibitors in patients with cirrhosis.British journal of clinical pharmacology · 2018Article
Corrections and comments
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Authors and funding
13 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimThe aim of this study was to assess the impact of proton pump inhibitor (PPI) intake on the development of spontaneous bacterial peritonitis (SBP) or other infections, as well as on mortality, in a thoroughly documented cohort of patients with cirrhosis and ascites. PATIENTS AND
methodsWe performed a retrospective analysis of follow-up data from 607 consecutive patients with cirrhosis undergoing their first paracentesis at a tertiary center. A binary logistic regression model investigating the association between PPI intake and SBP at the first paracentesis was calculated. Competing risk analyses and Cox models were used to investigate the effect of PPIs on the cumulative incidence of SBP or other infections and transplant-free survival, respectively. Adjustments were made for age, hepatocellular carcinoma, history of variceal bleeding, varices and model of end-stage liver disease score.
resultsEighty-six percent of patients were receiving PPIs. After adjusting for potential confounding factors, PPI intake was neither associated with increased SBP prevalence at the first paracentesis (odds ratio (OR):1.11,95% confidence interval (95%CI):0.6-2.06; P = 0.731) nor cumulative incidence of SBP (subdistribution hazard ratio (SHR): 1.38; 95%CI:0.63-3.01; P = 0.42) and SBP or other infections (SHR:1.71; 95%CI:0.85-3.44; P = 0.13) during follow-up. Moreover, PPI intake had no impact on transplant-free survival in both the overall cohort (hazard ratio (HR):0.973,95%CI:0.719-1.317; P = 0.859) as well as in the subgroups of patients without SBP (HR:1.01,95%CI:0.72-1.42; P = 0.971) and without SBP or other infections at the first paracentesis (HR:0.944,95%CI:0.668-1.334; P = 0.742).
conclusionsThe proportion of cirrhotic patients with PPI intake was higher than in previous reports, suggesting that PPI indications were interpreted liberally. In our cohort with a particularly high prevalence of PPI intake, we observed no association between PPIs and SBP or other infections, as well as mortality. Thus, the severity of liver disease and other factors, rather than PPI treatment per se may predispose for infectious complications.
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