Proton pump inhibitor-associated pneumonia: Not a breath of fresh air after all?

Table 3 Community-acquired pneumonia based on proton pump inhibitor exposure

PPI exposure	Case patients	Control participants	Odds Ratio	P value
No PPI exposure	73 187	777 626	1	-
No PPI exposure in 30 d	3424	19 215	0.95	0.05
Current PPI exposure	3455	10 031	1.02	0.48
< 1.5 DDD	3056	9126	1	0.94
> 1.5 DDD	399	905	1.23	0.01
Duration of PPI Use (d)
< 2	64	54	6.53	< 0.001
< 7	124	148	3.8	< 0.001
< 14	204	288	3.16	< 0.001
< 30	469	1100	1.74	< 0.001
30-180	940	2447	1.09	0.11
>180	2046	6484	0.91	0.01

Adapted from Sarkar et al. As the daily dose of proton pump inhibitors administered to patients increases, the odds ratio for community-acquired pneumonia increases. Exposure greater than 1.5 times the defined daily dose (DDD) achieved statistical significance. Secondly as the duration of use decreases, the odds ratio of community-acquired pneumonia increases suggesting that there may be some confounding factors with starting proton pump inhibitor therapy and pneumonia. DDD: defined daily dose.