Korean Journal of Clinical Pharmacy (한국임상약학회지)

Korean College Of Clinical Pharmacy (한국임상약학회)
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Comparison of Histamine 2 Receptor Antagonists and Proton Pump Inhibitors on Infectious Complications in Critically Ill Patients

중환자에서 스트레스성 궤양 예방 약물에 따른 감염성 합병증 발생률 비교

  • Park, Sun young (Graduate School of Clinical Health Sciences, Ewha Womans University) ;
  • Choi, Jae Hee (College of Pharmacy & Division of Life and Pharmaceutical Sciences and Graduate School of Clinical Health Sciences, Ewha Womans University) ;
  • Youn, Young Ju (Department of Pharmacy, Gangnam Severance Hospital) ;
  • Rhie, Sandy Jeong (Graduate School of Clinical Health Sciences, Ewha Womans University)
  • 박선영 (이화여자대학교 임상보건과학대학원) ;
  • 최재희 (이화여자대학교 약학대학) ;
  • 윤영주 (강남세브란스병원 약제부) ;
  • 이정연 (이화여자대학교 임상보건과학대학원)
  • Received : 2015.12.28
  • Accepted : 2016.03.14
  • Published : 2016.03.31
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Abstract

Background: The use of acid suppressive agents became a standard therapy in an intensive care unit (ICU) to prevent stress related gastrointestinal mucosal damage. However, the risk of infectious diseases has been concerned. Objective: The study was to determine the differences between histamine 2 receptor antagonists (H2RA) and proton pump inhibitors (PPI) in incidence of nosocomial pneumonia and pseudomembranous colitis (PMC) by Clostridium difficile with patients in ICU. Methods: This is a retrospective comparative study including patients admitted to the ICU who were at least 18 years of age and stayed for more than 48hrs from August 1, 2014 to January 31, 2015. The propensity score analysis and propensity matched multivariable logistic regression were used in analyzing data to control for confounders. Results: A total of 155 patients were assessed. H2RA were prescribed in 110 (53.9%) and PPI were in 45 (22.1%). Nosocomial pneumonia developed in 37 (23.9%); 25 (22.7%) were on H2RA and 12 (26.7%) were on PPI. The unadjusted incidence of nosocomial pneumonia was slightly higher in the patients with PPI (odds ratio (OR) 1.24; 95% confidence interval (CI): 0.54-2.71) compared to them with H2A. After adjusting with propensity score, the adjusted OR with PPI was 1.35 (95% CI: 0.44-4.11). The propensity score matched analyses showed similar results. Conclusion: The uses of PPI and H2RA as a stress ulcer prophylaxis agent showed similarity in the incidence of nosocomial pneumonia and PMC.

Keywords

References

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