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Protonix Ups Pneumonia Risks

Sep 16, 2009 | Parker Waichman Alonso LLP

Protonix, the popular stomach-acid medication, has been linked to increased pneumonia risks. Science Daily explained that Protonix, when used to prevent stress ulcers in critically ill patients on ventilation, presents a three-fold increase for pneumonia, citing Wake Forest University School of Medicine research

Science Daily explained that in critically ill patients, hospital-acquired pneumonia is the number one cause of infection-related deaths and increases hospital stay time by about seven-to-nine days, cost of care, and other complications. “As best we can tell, patients who develop hospital-acquired pneumonia or ventilator-acquired pneumonia have about a 20 to 30 percent chance of dying from that pneumonia,” said senior study author David L. Bowton, M.D., professor and head of the Section on Critical Care in the Department of Anesthesiology, quoted Science Daily. “It’s a significant event,” Doctor Bowton added.

The study was published in a recent issue of CHEST and looked at treatment with two medications that reduce stomach acid: ZantacTM (generic: ranitidine) and ProtonixTM (generic: pantoprazole), said Science Daily. While both Protonix and Zantac reduce stomach acid. Protonix, which is newer, is believed to be stronger and has become, said Science Daily, “the drug of choice in many hospitals.’

The analysis of over 830 patient charts revealed that cardiothoracic surgery patients who were hospitalized and treated with Protonix experienced a three-fold greater chance of developing pneumonia. “We conducted this study, in part, because we thought we were seeing more pneumonias than we were used to having,” said study co-author Marc G. Reichert, Pharm.D., pharmacy coordinator for surgery at Wake Forest University Baptist Medical Center, quoted Science Daily.

Both medications better enable the colonization of bacteria in the stomach and ventilator patients can develop pneumonia when reflux causes stomach acids to enter the lungs, said Science Daily. In addition to following other existing therapies, such as raising the ventilator patients’ heads, the study suggests doctors seriously consider if an acid reducer is necessary, said Dr. Bowton, and use another drug, such as ranitidine, which has a lower pneumonia risk, said Science Daily. “Stopping the drugs earlier appears to be the best thing for patients,” Reichert said.

PPIs—Proton Pump Inhibitors—such as Protonix, are taken by millions of people; however, PPIs have been the subject of safety concerns in recent months. As we’ve reported previously, a recent Canadian study of PPIs and osteoporosis-related fractures revealed a link between long-term PPI use and increased risk for hip, wrist, or spine fractures. We also reported in May that Plavix—another PPI—users were warned by the Society for Cardiovascular Angiography and Interventions (SCAI) to avoid PPIs following stent implantation because the combination increases the risks for heart attack (by 70 percent), stroke (48 percent), and other cardiovascular problems (repeat heart procedures by 35 percent). And most recently, we reported on another study out of Canada that found a connection between routine prescription of PPIs during hospitalizations and an increased risk—30 percent—of acquiring pneumonia.

In July, we wrote that PPIs could lead to dependency if taken at prescription strength over an extended period of time, citing emerging research.