Popular Antacid Linked to Bacterial Infections, Bone Fractures
It’s estimated that millions of Americans, adults and children alike, suffer with gastroesophageal reflux disease (GERD), the most common symptom of which is acid reflux.
Each year, 113.4 million prescriptions for antacids are filled, while many others are purchased over the counter. A new study, however, finds that some of the most commonly used acid reflux medications, known as proton pump inhibitors (PPIs), may cause unwanted side effects such as bacterial infections and bone fractures in post-menopausal women.
The study, published in the May 10 issue of “Archives of Internal Medicine,” a JAMA publication, also finds that between 53 and 69 percent of these medications are being taken for inappropriate indications.
But PPIs, which include Prilosec, Prevacid, Nexium, Aciphex and Protonix are a big business. Dr. Mitchell H. Katz, of the San Francisco Department of Public Health, who wrote an editorial accompanying the study, says this class of drugs, with $13.9 billion in sales per year, is now the third-highest pharmaceutical seller in the United States.
“All drugs have adverse effects, but that alone is not a reason to avoid them,” writes Katz. “Rather, prior to prescribing medications, good clinicians must weigh the benefits versus the risks and the seriousness of the disease versus the seriousness of the adverse effects.”
PPIs effectively treat inflammation of the esophagus, GERD, ulcers and several other conditions. They are also often used to treat dyspepsia, or indigestion, in the absence of ulcers, inflammation or severe GERD.
Prilosec and Prevacid were once only available by prescription, but are now sold over the counter. Nexium, AcipHex and Protonix are available by prescription only.
Although antacids can relieve indigestion, new studies show that the risks of using them may outweigh the benefits, and that doctors and clinicians should be less liberal in handing out prescriptions for these medications or advising patients to go out and purchase them over the counter.
Dr. Michael D. Howell, of Beth Israel Deaconess Medical Center and Harvard Medical School, and colleagues analyzed more than 100,000 patients discharged from hospitals in a five-year period. They discovered that daily proton pump inhibitor use is associated with an estimated 74 percent increase in infection with clostridium difficile, a bacteria that is often picked up in hospitals by older patients.
“The stomach juices, or acids, in the stomach usually kill off this type of bacteria,” Howell told AOL Health. Taking an antacid creates an absence of stomach acids that makes patients more susceptible to picking up the potentially lethal bacteria.
“For every 14 people that pick up this bacteria, one dies,” Howell added. “For years we thought proton pump inhibitors were completely safe. I think the main message to come out of our study is that prescribers need to pay attention to even small increases in risks.”
Howell said that in many hospitals, PPIs are given as preventative medicine to decrease the risk of possible stomach bleeding in patients that are at risk for this condition, such as those who have previously experienced bleeding ulcers or are on an aspirin regimen to reduce the risk of a heart attack.
“I would encourage my own family to ask the doctor if the drug is being given for a specific reason,” he said. “It’s true that PPIs can decrease the chance of bleeding by 80 percent, but the risk of most patients experiencing stomach bleeding is low.”
Howell says that approximately 50 percent of hospital patients are put on these drugs, totaling about 35 million people per year. And prolonged use of the drug isn’t necessary in order to experience the bad side effects. “What surprised us was that just taking the drug for a few days can increase your risk,” he added.
