Antacid Overuse Sickens Montreal Patients-Study

Overuse of a popular antacid has increased the risk of severe and potentially fatal diarrhea in patients in Montreal hospitals, a research study published in the Canadian Medical Association Journal warned on Friday.

Overuse of a popular antacid has increased the risk of severe and potentially fatal diarrhea in patients in Montreal hospitals, a research study published in the Canadian Medical Association Journal warned on Friday. The study links the increasing prevalence of clostridium, an organism that causes severe diarrhea, in Montreal hospitals to the increased use of proton pump inhibitors, a powerful antacid used to treat peptic ulcers and esophageal reflux disease. It also found that using antibiotics while taking the antacid added to the risks of getting clostridium. “Our research found that patients were twice as likely to get the disease if they were on antibiotics and proton pump inhibitors than those who were just on antibiotics,” Dr. Sandra Dial, who led the study, told Reuters. Antibiotics change the normal bowel flora, and the proton pump inhibitors lower the stomach’s acidity, allowing the bug to pass into the gut. Dial’s study looked at 1,187 patients in a Montreal teaching hospital, where the incidence of clostridium had increased “significantly” in 2003 from 2002. It did not say by how much the disease had increased. Around half of the 1,187 patients were prescribed antibiotics and antacids, and the other half were prescribed just antibiotics. Of the total number, 81 developed clostridium, 55 of whom had taken antibiotics and the antacid. At the same time, the researchers looked at 94 patients who already had clostridium. The study found that within 30 days of being diagnosed with clostridium, 21 patients had died. The study concluded that patients who developed clostridium diarrhea “had substantial mortality and morbidity. We found that the use of proton pump inhibitors was independently associated with an increased risk of (clostridium) diarrhea.” Dial, a critical care physician at the Montreal Chest Institute, said she believed clostridium was more prevalent in Montreal because proton pump inhibitors are readily available in Quebec hospitals. “Proton pump inhibitors are restricted in hospitals in most provinces because of their cost,” she said. “In Quebec and Alberta they are not.” Hospitals in Calgary, Alberta, quelled a similar outbreak of the infection in 2000-2001, and a less virulent strain has recently resurfaced, the CMAJ said. Dial said she had presented her findings to a number of Montreal hospitals, and suggested that patients switch to milder antacids if their conditions do not warrant the more powerful proton pump inhibitors. “The hospitals are very concerned about the disease. They haven’t gone as far as introducing restrictions for proton pump inhibitors, but I think I might have convinced them there may be something that should be looked at,” she said.(Source: Reuters Health, June 2004)