INCREASED INCIDENCE OF BACTERIAL DIARRHEA IN PATIENTS TAKING GASTRIC-ACID ANTISECRETORY DRUGS

被引：22

作者：

NWOKOLO, CU

LOFT, DE

HOLDER, R

LANGMAN, MJS

机构：

[1] Department of Gastroenterology, Walsgrave Hospital, Coventry

[2] Departments of Medicine and Statistics, University of Birmingham, Birmingham

来源：

EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY | 1994年 / 6卷 / 08期

关键词：

BACTERIAL DIARRHEA; H-2-ANTAGONISTS; OMEPRAZOLE; RANITIDINE; CIMETIDINE; SALMONELLAE; SHIGELLAE; CAMPYLOBACTERS; GASTRIC ACIDITY;

D O I：

10.1097/00042737-199408000-00009

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Objective: Hypochlorhydria encourages the colonization of the foregut by potentially pathogenic bacteria. We compared the frequency of bacterial diarrhoea in patients taking antisecretory, anti-asthmatic and hypotensive drugs. Design: A retrospective study. Patients with bacterial diarrhoea were sent questionnaires asking about the use of gastric acid suppressor (cimetidine, ranitidine, omeprazole) or anti-asthmatic (salbutamol tablets) and hypotensive (nifedipine) drugs. The number of prescriptions of these five drugs within the Coventry Family Health Service Authority (FHSA) during the 1-year study period were obtained from the Prescription Pricing Authority. Patients: The study included 277 patients (>18 years of age), stool-culture-positive for campylobacters, shigellae and salmonellae, who were notified by general practitioners in the Coventry FHSA to the Department of Public Health Medicine, Coventry, in the year ending 30 September 1992. Main outcome measures: Incidence of bacterial diarrhoea in patients taking antisecretory, anti-asthmatic and hypotensive drugs, taking the local prescription rates of the drugs into account. Results: There was a 54% response rate. Of the patients receiving acid suppressor drugs, one case of bacterial diarrhoea occurred for every 5149 prescriptions [95% confidence interval (CI) 2878-103171 compared with 16665 (95% CI 5700-80769) for patients receiving anti-asthmatic and hypotensive drugs (P= 0.048, GLIM analysis). Subset analysis of acid suppressor drugs showed that the number of prescriptions associated with one case of diarrhoea decreased non-significantly with increasing gastric antisecretory potency: 9337, 4474 and 3319 for cimetidine, ranitidine and omeprazole, respectively. Conclusions: Overall, patients taking acid suppressor drugs appear to have approximately three times the risk of bacterial diarrhoea than non-recipients.

引用

页码：697 / 699

页数：3

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