In this case control study of cirrhotics with ascites, those on PPIs had a much higher risk of SBP than those not on PPIs (adjusted OR 4.3), and about half of the patients on PPIs had no indication. Although this study can not establish causality, it reminds us to review the necessity of PPIs in all inpatients, given the mounting evidence of potential harm of PPIs (risk of pneumonia, Clostridium difficile, fractures, and lower clopidogrel efficacy) (abstract).
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.