Comparison Among Proton Pump Inhibitor Inducing Pneumonia  in Hospital: Narrative Review

Juwita Permata Sari; Agung Endro Nugroho; Widyati Widyati

doi:10.22146/farmaseutik.v20i3.88612

Comparison Among Proton Pump Inhibitor Inducing Pneumonia in Hospital: Narrative Review

https://doi.org/10.22146/farmaseutik.v20i3.88612

Juwita Permata Sari^(1*), Agung Endro Nugroho⁽²⁾, Widyati Widyati⁽³⁾

(1) Master of Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada
(2) Departement of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada
(3) Faculty of Pharmacy, Universitas Pertahanan
(*) Corresponding Author

Abstract

Critically ill patients requiring intensive care unit (ICU) are highly vulnerable to the emergence of stress-related gastrointestinal bleeding, a condition closely associated with unfavorable clinical outcomes. Despite advancements in preventive measures, antimicrobial therapies, and supportive medical care, ventilator-associated pneumonia (VAP) and hospital-acquired pneumonia (HAP) continue to effect morbidity and mortality rates significantly. Hospital-acquired pneumonia (HAP) is characterized as a form of pneumonia that does not manifest during the period of hospital admission but rather emerges 48 hours or later after the patient has been admitted. In contrast, VAP occurs after 48 hours of having an endotracheal tube in place. Proton pump inhibitors (PPIs) are used prophylactically to manage stress ulcers in critically ill patients. However, recent scholarly literature has drawn attention to a potential link between using acid-suppressing medications and an increased susceptibility to pneumonia. The precise mechanism through which these acid suppressors might elevate the risk of pneumonia remains unclear. The primary objective of this study was to assess the prevalence of pneumonia associated with different types of proton pump inhibitors. We conducted an extensive literature search using keywords such as "(omeprazole or pantoprazole or lansoprazole or esomeprazole or rabeprazole), ICU, Pneumonia" on two prominent electronic databases: Scopus and PubMed. We identified fourteen articles meeting our inclusion criteria, which were categorized into four groups based on the type of proton pump inhibitor: omeprazole, esomeprazole, lansoprazole, and pantoprazole. The results of this narrative review revealed varying risk levels associated with using different proton pump inhibitors for pneumonia. Esomeprazole had the highest risk level, at 48.84%, followed by lansoprazole at 27.85%, omeprazole at 22.5%, and pantoprazole at 19.94%.

Keywords

Pneumonia; Omeprazole; Pantoprazole; Lansoprazole; Esomeprazole

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DOI: https://doi.org/10.22146/farmaseutik.v20i3.88612