Pharmacotherapy and the risk for community-acquired pneumonia

<p>Abstract</p> <p>Background</p> <p>Some forms of pharmacotherapy are shown to increase the risk of community-acquired pneumonia (CAP). The purpose of this study is to investigate whether pharmacotherapy with proton pump inhibitors (PPI), inhaled corticosteroids, and a...

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Main Authors: Mody Lona, Heh Victor, Khan Salman, Acharya Utkarsh, Gau Jen-Tzer, Kao Tzu-Cheg
Format: Article
Language:English
Published: BMC 2010-07-01
Series:BMC Geriatrics
Online Access:http://www.biomedcentral.com/1471-2318/10/45
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spelling doaj-320bf396537d47ef90f2661b12b361cd2020-11-25T01:38:37ZengBMCBMC Geriatrics1471-23182010-07-011014510.1186/1471-2318-10-45Pharmacotherapy and the risk for community-acquired pneumoniaMody LonaHeh VictorKhan SalmanAcharya UtkarshGau Jen-TzerKao Tzu-Cheg<p>Abstract</p> <p>Background</p> <p>Some forms of pharmacotherapy are shown to increase the risk of community-acquired pneumonia (CAP). The purpose of this study is to investigate whether pharmacotherapy with proton pump inhibitors (PPI), inhaled corticosteroids, and atypical antipsychotics was associated with the increased risk for CAP in hospitalized older adults with the adjustment of known risk factors (such as smoking status and serum albumin levels).</p> <p>Methods</p> <p>A retrospective case-control study of adults aged 65 years or older at a rural community hospital during 2004 and 2006 was conducted. Cases (N = 194) were those with radiographic evidence of pneumonia on admission. The controls were patients without the discharge diagnosis of pneumonia or acute exacerbation of chronic obstructive pulmonary disease (COPD) (N = 952). Patients with gastric tube feeding, ventilator support, requiring hemodialysis, metastatic diseases or active lung cancers were excluded.</p> <p>Results</p> <p>Multiple logistic regression analysis revealed that the current use of inhaled corticosteroids (adjusted odds ratio [AOR] = 2.89, 95% confidence interval [CI] = 1.56-5.35) and atypical antipsychotics (AOR = 2.26, 95% CI = 1.23-4.15) was an independent risk factor for CAP after adjusting for confounders, including age, serum albumin levels, sex, smoking status, a history of congestive heart failure, coronary artery disease, and COPD, the current use of PPI, β2 agonist and anticholinergic bronchodilators, antibiotic(s), iron supplement, narcotics, and non-steroidal anti-inflammatory drugs. The crude OR and the AOR of PPI use for CAP was 1.41 [95% CI = 1.03 - 1.93] and 1.18 [95% CI = 0.80 - 1.74] after adjusting for the above confounders, respectively. Lower serum albumin levels independently increased the risk of CAP 1.89- fold by decreasing a gram per deciliter (AOR = 2.89, 95% CI = 2.01 - 4.16).</p> <p>Conclusion</p> <p>Our study reaffirmed that the use of inhaled corticosteroids and atypical antipsychotics was both associated with an increased risk for CAP in hospitalized older adults of a rural community. No association was found between current PPI use and the risk for CAP in this patient population of our study.</p> http://www.biomedcentral.com/1471-2318/10/45
collection DOAJ
language English
format Article
sources DOAJ
author Mody Lona
Heh Victor
Khan Salman
Acharya Utkarsh
Gau Jen-Tzer
Kao Tzu-Cheg
spellingShingle Mody Lona
Heh Victor
Khan Salman
Acharya Utkarsh
Gau Jen-Tzer
Kao Tzu-Cheg
Pharmacotherapy and the risk for community-acquired pneumonia
BMC Geriatrics
author_facet Mody Lona
Heh Victor
Khan Salman
Acharya Utkarsh
Gau Jen-Tzer
Kao Tzu-Cheg
author_sort Mody Lona
title Pharmacotherapy and the risk for community-acquired pneumonia
title_short Pharmacotherapy and the risk for community-acquired pneumonia
title_full Pharmacotherapy and the risk for community-acquired pneumonia
title_fullStr Pharmacotherapy and the risk for community-acquired pneumonia
title_full_unstemmed Pharmacotherapy and the risk for community-acquired pneumonia
title_sort pharmacotherapy and the risk for community-acquired pneumonia
publisher BMC
series BMC Geriatrics
issn 1471-2318
publishDate 2010-07-01
description <p>Abstract</p> <p>Background</p> <p>Some forms of pharmacotherapy are shown to increase the risk of community-acquired pneumonia (CAP). The purpose of this study is to investigate whether pharmacotherapy with proton pump inhibitors (PPI), inhaled corticosteroids, and atypical antipsychotics was associated with the increased risk for CAP in hospitalized older adults with the adjustment of known risk factors (such as smoking status and serum albumin levels).</p> <p>Methods</p> <p>A retrospective case-control study of adults aged 65 years or older at a rural community hospital during 2004 and 2006 was conducted. Cases (N = 194) were those with radiographic evidence of pneumonia on admission. The controls were patients without the discharge diagnosis of pneumonia or acute exacerbation of chronic obstructive pulmonary disease (COPD) (N = 952). Patients with gastric tube feeding, ventilator support, requiring hemodialysis, metastatic diseases or active lung cancers were excluded.</p> <p>Results</p> <p>Multiple logistic regression analysis revealed that the current use of inhaled corticosteroids (adjusted odds ratio [AOR] = 2.89, 95% confidence interval [CI] = 1.56-5.35) and atypical antipsychotics (AOR = 2.26, 95% CI = 1.23-4.15) was an independent risk factor for CAP after adjusting for confounders, including age, serum albumin levels, sex, smoking status, a history of congestive heart failure, coronary artery disease, and COPD, the current use of PPI, β2 agonist and anticholinergic bronchodilators, antibiotic(s), iron supplement, narcotics, and non-steroidal anti-inflammatory drugs. The crude OR and the AOR of PPI use for CAP was 1.41 [95% CI = 1.03 - 1.93] and 1.18 [95% CI = 0.80 - 1.74] after adjusting for the above confounders, respectively. Lower serum albumin levels independently increased the risk of CAP 1.89- fold by decreasing a gram per deciliter (AOR = 2.89, 95% CI = 2.01 - 4.16).</p> <p>Conclusion</p> <p>Our study reaffirmed that the use of inhaled corticosteroids and atypical antipsychotics was both associated with an increased risk for CAP in hospitalized older adults of a rural community. No association was found between current PPI use and the risk for CAP in this patient population of our study.</p>
url http://www.biomedcentral.com/1471-2318/10/45
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