Proton-Pump Inhibitors: Reducing their Unnecessary Use

While proton-pump inhibitors (PPIs) have beneficial therapeutic and prophylactic indications for many patients, increasing evidence suggests that these medications are not without risk; inpatient use of PPIs has been shown to increase the risk of hospital-acquired pneumonia by up to 30% [2]. Community-acquired pneumonia is also more common in patients who have started PPI therapy within the past 30 days [5]. The use of proton-pump inhibitors has been associated with an increased risk of primary and recurrent Clostridium difficile infections [3]. Their long term use has also been linked to an increased risk of fractures in older adults, though the mechanism for this association remains unclear; PPI use has not been clearly linked to osteoporosis or increased loss of bone mineral density [1].