Absence of gastrointestinal infections in a cohort of patients with Zollinger-Ellison syndrome and other acid hypersecretors receiving long-term acid suppression with lansoprazole.

Abstract

BACKGROUND:

The relationship between proton pump inhibitor therapy and other acid suppressing medications and the risk of gastrointestinal infections remains controversial.

METHODS:

Patients enrolled in a long-term trial of lansoprazole for Zollinger-Ellison syndrome and other acid hypersecretory states had interval histories taken every six months regarding hospitalizations or other intercurrent medical conditions. All medications taken were also reviewed at each visit. In addition, available patients were specifically queried during the study period 2006-2007 regarding the development of any gastrointestinal infections, hospitalizations, and prescriptions for antibiotics.

RESULTS:

Ninety patients were enrolled in our long-term study and 81 were available for review. The median basal gastric pH for the cohort after stabilization on therapy was 2.9 and ranged from 1.1 - 8.4 with a median pentagastrin stimulated gastric pH of 1.60 (range 1.0 - 8.2). No patient developed a clinically significant gastrointestinal infection during the study. The median patient years of follow-up were 6.25 years.

CONCLUSION:

In a cohort of patients with gastric acid hypersecretion in whom acid secretion status was monitored on lansoprazole, all were free of significant gastrointestinal infections on long-term follow-up.

TRIAL REGISTRATION:

NCT00204373.

• Authors: C Mel Wilcox, Toni Martin, Milind Phadnis, Jean Mohnen, Julie Worthington, Basil I Hirschowitz
• Journal: BMC gastroenterology (BMC Gastroenterol) Vol. 8 Pg. 18 (May 28 2008) ISSN: 1471-230X [Electronic] England
• PMID: 18507843 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• 2-Pyridinylmethylsulfinylbenzimidazoles
• Anti-Infective Agents
• Anti-Ulcer Agents
• Proton Pump Inhibitors
• Lansoprazole

Topics

• 2-Pyridinylmethylsulfinylbenzimidazoles (therapeutic use)
• Adult
• Aged
• Aged, 80 and over
• Anti-Infective Agents (therapeutic use)
• Anti-Ulcer Agents (therapeutic use)
• Clostridioides difficile (pathogenicity)
• Cohort Studies
• Dose-Response Relationship, Drug
• Enterocolitis, Pseudomembranous (diagnosis, etiology)
• Female
• Follow-Up Studies
• Gastric Acid (metabolism)
• Gastrointestinal Diseases (diagnosis, etiology, microbiology)
• Gastrointestinal Tract (microbiology)
• Humans
• Hydrogen-Ion Concentration
• Incidence
• Lansoprazole
• Longitudinal Studies
• Male
• Middle Aged
• Prospective Studies
• Proton Pump Inhibitors (therapeutic use)
• Zollinger-Ellison Syndrome (complications, drug therapy, metabolism)