Relationship between proton pump inhibitor therapy and spontaneous bacterial peritonitis in cirrhotic patients with ascites

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  • Matsumoto Shuichi
    Department of Hepatology, Fukuoka Tokushukai Medical Center Department of General Internal Medicine, Fukuoka Tokushukai Medical Center
  • Takizawa Naoho
    Department of General Internal Medicine, Fukuoka Tokushukai Medical Center
  • Kaneyama Yasunari
    Department of General Internal Medicine, Fukuoka Tokushukai Medical Center
  • Miyai Hitoki
    Department of General Internal Medicine, Fukuoka Tokushukai Medical Center
  • Kodama Nobuhiro
    Department of General Internal Medicine, Fukuoka Tokushukai Medical Center
  • Matsubayashi Sunao
    Department of Psycosomatic Medicine, Fukuoka Tokushukai Medical Center

Bibliographic Information

Other Title
  • 腹水を有する肝硬変患者におけるプロトンポンプ阻害薬と特発性細菌性腹膜炎の関連
  • フクスイ オ ユウスル カンコウヘン カンジャ ニ オケル プロトンポンプ ソガイヤク ト トクハツセイ サイキンセイ フクマクエン ノ カンレン

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Description

Objective. To demonstrate the relationship between proton pump inhibitor (PPI) and spontaneous bacterial peritonitis (SBP) in cirrhotic patients with ascites. Material and Method. A total of 157 cirrhotic patients with ascites who underwent diagnostic paracentesis from January 2006 to October 2011 were included. SBP was defined as more than 250/mm3 polymorphonuclear leukocytes with or without a positive culture from the ascitec fluid. Result. 38 patients had SBP and 119 did not. On multivariate analysis, hepatocellular carcinoma (OR=5.09, 95% CI 2.09-13.05; p<0.01), MELD score (>=20, OR=3.57, 95% CI 1.40-9.69, p<0.01), PPI use (OR=2.60, 95% CI 1.13-6.12; p=0.02) were risk factor for SBP. Conclusion. PPI use, as well as with hepatocellular carcinoma and high MELD score, was an independent risk factor for the development of SBP in cirrhotic patients with ascites. We recommend that we should use carefully PPI to cirrhotic patients with ascites. Further prospective studies are warranted to clarify this issue.

Journal

  • Kanzo

    Kanzo 55 (9), 530-536, 2014

    The Japan Society of Hepatology

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