Patients taking a popular stomach-acid reducing drug were three times more likely to develop pneumonia, a new study says. Researchers at Wake Forest University School of Medicine compared treatment with two drugs that decrease stomach acid: ranitidine, marketed under the name Zantac, and pantoprazole, marketed under the name Protonix or Prilosec. Both drugs decrease stomach acid, but pantoprazole is considered more powerful and has become the drug of choice in many hospitals. However, when looking at 834 patient charts, the researchers found that hospitalized cardiothoracic surgery patients treated with pantoprazole were three times more likely to develop pneumonia.

 

“We conducted this study, in part, because we thought we were seeing more pneumonias than we were used to having,” says study co-author Marc Reichert, pharmacy coordinator for surgery at Wake Forest University Baptist Medical Center.

Both acid-reducing drugs can make the stomach a more hospitable place for bacteria to grow. Patients on breathing machines sometimes develop pneumonia when stomach secretions reflux into the lungs.

 

The researchers note in the article published in CHEST that hospital-acquired pneumonia is the leading cause of infection-related deaths in critically ill patients. It increases hospital stays by an average of seven to nine days. It also increases the cost of care and the risk of 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,” says senior study author David Bowton, professor and head of the Section on Critical Care in the Department of Anesthesiology. “It's a significant event.”

 

Current treatment guidelines to prevent pneumonia recommend raising the head of the bed for patients on breathing machines, which reduces the risk of stomach secretions getting into the lungs. But the study's findings suggest some other steps could keep critically ill patients from developing ventilator-associated pneumonia.

 

Doctors should consider whether an acid reducer is needed at all, Bowton says. He says that in cases where an acid reducer is needed, ranitidine is recommended, because of the apparent decreased risk in developing pneumonia.