New evidence is linking proton pump inhibitors with an increased risk of an intestinal disorder called Clostridium difficile-associated diarrhea (CDAD). According to a study presented at the American Academy of Family Physicians (AAFP) 2010 Scientific Assembly, increased use of the popular heartburn drugs at one hospital coincided with increased incidence of CDAD.
Proton pump inhibitors, available by prescription and over-the-counter (OTC), work by reducing the amount of acid in the stomach, and are approved to treat conditions such as gastroesophageal reflux disease (GERD), stomach and small intestine ulcers, and inflammation of the esophagus. Prescription versions of the drugs include Nexium, Dexilant, Prilosec, Zegerid, Prevacid, Protonix, and Aciphex. OTC brands include Prilosec OTC, Zegerid OTC and Prevacid 24HR.
Since their introduction in the 90s, proton pumps have ranked among the top selling drugs, with doctors writing 119 million prescriptions for them last year alone.
For this latest study, a research team from Saint Joseph Regional Medical Center in South Bend, Indiana collected information on the number of antibiotic prescriptions ordered at the hospital between 2000 and 2009, as well as the number of proton pump inhibitor prescriptions ordered, the number of cases of CDAD indicating C difficile-associated disease, and the number of inpatient admissions during the same time period.
As the use of the heartburn drugs by patients increased, so did CDAD; a similar event occurred with increasing antibiotic use, the research team said.
Concerns about potential overuse and misuse of proton pump inhibitors have been rising for some time, and this study will likely add to those. Other side effects of proton pump inhibitors include pneumonia and fractures, and there are concerns that they could interfere with the effectiveness of the heart drug, Plavix.
Proton Pump inhibitors are indicated for short term use, but in many cases people take the drugs for far longer than they should. According to a recent report in the Minneapolis Star Tribune, several studies have suggested that many people are taking proton pump inhibitors for no apparent reason. For example, a 2005 review of patient charts in one Michigan hospital found that 60 percent of those taking the drugs were doing so without a valid reason. In May, an editorial in the Archives of Internal Medicine claimed that 53 to 69 percent of the prescriptions for acid suppressors are “for inappropriate indications.”