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Pantoprazole Triples Risk of Pneumonia in Critically Ill Patients WINSTON-SALEM, NC -- September 14, 2009 -- Use of pantoprazole in critically ill patients needing breathing machine support triples the risk of those patients contracting pneumonia, according to a study published in a recent issue of the journal CHEST. "As best we can tell, patients who develop hospital-acquired pneumonia or ventilator-acquired pneumonia have about a 20% to 30% chance of dying from that pneumonia," said senior author David L. Bowton, MD, Section on Critical Care, Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina. "It's a significant event." The study compared treatment with ranitidine (Zantac) and pantoprazole (Protonix, Prilosec). In the analysis of 834 patient charts, the researchers found that hospitalised cardiothoracic surgery patients treated with pantoprazole were 3 times more likely to develop pneumonia. Both acid-reducing drugs can make the stomach a more hospitable place for bacteria to colonize. Patients on breathing machines sometimes develop pneumonia when stomach secretions reflux into the lungs. 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. Physician should consider whether an acid reducer is needed at all, said Dr. Bowton. The occurrence of stress ulcer bleeding has gone down in recent years, perhaps because patients with breathing tubes are fed earlier, and food in the stomach may neutralise or reduce the effects of stomach acid. Bowton added that in cases where an acid reducer is needed, ranitidine is recommended, given the apparent decreased risk in developing pneumonia. Physicians should discontinue the drug as soon as the risk of bleeding passes -- once the patient is off the breathing machine and eating, either on his/her own or through a feeding tube. SOURCE: Wake Forest University Baptist Medical Center E-mail this page to a friend or colleague! To print, use this version