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Incidence of campylobacter and salmonella infections following first prescription for PPI: a cohort study using routine data

Incidence of campylobacter and salmonella infections following first prescription for PPI: a cohort study using routine data
Incidence of campylobacter and salmonella infections following first prescription for PPI: a cohort study using routine data
OBJECTIVES: To examine the incidence of Campylobacter and Salmonella infection in patients prescribed proton pump inhibitors (PPIs) compared with controls. METHODS: Retrospective cohort study using anonymous general practitioner (GP) data. Anonymised individual-level records from the Secure Anonymised Information Linkage (SAIL) system between 1990 and 2010 in Wales were selected. Data were available from 1,913,925 individuals including 358,938 prescribed a PPI. The main outcome measures examined included incidence of Campylobacter or Salmonella infection following a prescription for PPI. RESULTS: The rate of Campylobacter and Salmonella infections was already at 3.1?6.9 times that of non-PPI patients even before PPI prescription. The PPI group had an increased hazard rate of infection (after prescription for PPI) of 1.46 for Campylobacter and 1.2 for Salmonella, compared with baseline. However, the non-PPI patients also had an increased hazard ratio with time. In fact, the ratio of events in the PPI group compared with the non-PPI group using the prior event rate ratio was 1.17 (95% CI 0.74?1.61) for Campylobacter and 1.00 (0.5?1.5) for Salmonella. CONCLUSIONS: People who go on to be prescribed PPIs have a greater underlying risk of gastrointestinal (GI) infection beforehand and they have a higher prevalence of risk factors before PPI prescription. The rate of diagnosis of infection is increasing with time regardless of PPI use, and there is no evidence that PPI is associated with an increase in diagnosed GI infection. It is likely that factors associated with the demographic profile of the patient are the main contributors to increased rate of GI infection for patients prescribed PPIs.
0002-9270
1094-1100
Brophy, Sinead
7ae6819d-c175-4ec1-8239-9c94978743fa
Jones, Kerina H.
c5ecda86-feb7-43f5-bf6c-730f00753d8e
Rahman, Muhammad A.
72f36982-7d8d-41d1-bc6d-0394c416455c
Zhou, Shang-Ming
bc258d52-68da-4c26-beb3-f86a0ba5edd2
John, Ann
85d7c717-a69f-4d18-82a3-37a80eec3736
Atkinson, Mark D.
ff897534-1f2a-418a-9519-1351e71cfb62
Francis, Nick
9b610883-605c-4fee-871d-defaa86ccf8e
Lyons, Ronan A.
7e2b5912-18d1-4019-8091-5c9fc98f1a12
Dunstan, Frank David John
a73fc67f-3879-4f7d-b05d-c325187ed69e
Brophy, Sinead
7ae6819d-c175-4ec1-8239-9c94978743fa
Jones, Kerina H.
c5ecda86-feb7-43f5-bf6c-730f00753d8e
Rahman, Muhammad A.
72f36982-7d8d-41d1-bc6d-0394c416455c
Zhou, Shang-Ming
bc258d52-68da-4c26-beb3-f86a0ba5edd2
John, Ann
85d7c717-a69f-4d18-82a3-37a80eec3736
Atkinson, Mark D.
ff897534-1f2a-418a-9519-1351e71cfb62
Francis, Nick
9b610883-605c-4fee-871d-defaa86ccf8e
Lyons, Ronan A.
7e2b5912-18d1-4019-8091-5c9fc98f1a12
Dunstan, Frank David John
a73fc67f-3879-4f7d-b05d-c325187ed69e

Brophy, Sinead, Jones, Kerina H., Rahman, Muhammad A., Zhou, Shang-Ming, John, Ann, Atkinson, Mark D., Francis, Nick, Lyons, Ronan A. and Dunstan, Frank David John (2013) Incidence of campylobacter and salmonella infections following first prescription for PPI: a cohort study using routine data. American Journal of Gastroenterology, 108 (7), 1094-1100. (doi:10.1038/ajg.2013.30).

Record type: Article

Abstract

OBJECTIVES: To examine the incidence of Campylobacter and Salmonella infection in patients prescribed proton pump inhibitors (PPIs) compared with controls. METHODS: Retrospective cohort study using anonymous general practitioner (GP) data. Anonymised individual-level records from the Secure Anonymised Information Linkage (SAIL) system between 1990 and 2010 in Wales were selected. Data were available from 1,913,925 individuals including 358,938 prescribed a PPI. The main outcome measures examined included incidence of Campylobacter or Salmonella infection following a prescription for PPI. RESULTS: The rate of Campylobacter and Salmonella infections was already at 3.1?6.9 times that of non-PPI patients even before PPI prescription. The PPI group had an increased hazard rate of infection (after prescription for PPI) of 1.46 for Campylobacter and 1.2 for Salmonella, compared with baseline. However, the non-PPI patients also had an increased hazard ratio with time. In fact, the ratio of events in the PPI group compared with the non-PPI group using the prior event rate ratio was 1.17 (95% CI 0.74?1.61) for Campylobacter and 1.00 (0.5?1.5) for Salmonella. CONCLUSIONS: People who go on to be prescribed PPIs have a greater underlying risk of gastrointestinal (GI) infection beforehand and they have a higher prevalence of risk factors before PPI prescription. The rate of diagnosis of infection is increasing with time regardless of PPI use, and there is no evidence that PPI is associated with an increase in diagnosed GI infection. It is likely that factors associated with the demographic profile of the patient are the main contributors to increased rate of GI infection for patients prescribed PPIs.

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Published date: 1 July 2013

Identifiers

Local EPrints ID: 436300
URI: http://eprints.soton.ac.uk/id/eprint/436300
ISSN: 0002-9270
PURE UUID: 8ae997f6-0717-401c-a785-4a35a250bf02
ORCID for Nick Francis: ORCID iD orcid.org/0000-0001-8939-7312

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Date deposited: 06 Dec 2019 17:30
Last modified: 09 Jan 2022 04:08

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Contributors

Author: Sinead Brophy
Author: Kerina H. Jones
Author: Muhammad A. Rahman
Author: Shang-Ming Zhou
Author: Ann John
Author: Mark D. Atkinson
Author: Nick Francis ORCID iD
Author: Ronan A. Lyons
Author: Frank David John Dunstan

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