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首页> 外文期刊>The Journal of pharmacy technology: jPT : official publication of the Association of Pharmacy Technicians >Safety of Proton Pump Inhibitors in Community-Dwelling Older Adults
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Safety of Proton Pump Inhibitors in Community-Dwelling Older Adults

机译：质子泵抑制剂在社区老年人中的安全性

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Objective: To describe proton pump inhibitor (PPI)-related adverse effects in community-dwelling older adults.Data Sources: Articles were identified via PubMed (1966-March 2008) using the terms proton pump inhibitor, adverse drug effects, safety, pneumonia, fractures, Clostridium difficile, and vitamin B_(12). Clinical trials, meta-analyses, and drug evaluations published in English were selected. Articles excluding patients over 65 years of age or those involving solely institutionalized patients were excluded.Study Selection and Data Extraction: Twelve studies were selected, 10 of which were case-control or population-based studies. Three of 4 studies investigating the association of PPI use with C. difficile infection found a positive association. Many participants in these studies had no history of antibiotic exposure prior to infection. Three studies found a significant relationship between community-acquired pneumonia and PPI therapy, with a possible dose-response relationship. Two studies found an increased risk of fracture with PPI use, with a possible dose-response relationship. Two of 3 included studies found an association between vitamin B_(12) deficiency and PPI therapy.Data Synthesis: The majority of studies found significant associations between PPI use and the development of C. difficile infection, pneumonia, fractures, and vitamin B_(12) deficiency, all of which are plausible based on the mechanisms of action of PPIs. With a lack of randomized controlled trials, the. underlying causes of these adverse effects remain controversial.Conclusions: Cause and effect between PPI use and C. difficile infection, pneumonia, fractures, and vitamin B_(12) deficiency has not been established. Well-designed, prospective, randomized studies are required to confirm whether there are risks associated with long-term PPI use. Until the results of such studies become available, PPI use should be reviewed for appropriateness at regular intervals in individual patients, as the consequences of these complicationsin the elderly could be devastating.
机译：目的：描述质子泵抑制剂（PPI）对社区居民老年人的不良影响。数据来源：文章通过PubMed（1966年3月至2008年3月）使用质子泵抑制剂，药物不良反应，安全性，肺炎，骨折，艰难梭菌和维生素B_（12）。选择以英语发表的临床试验，荟萃分析和药物评估。排除65岁以上患者或仅涉及住院患者的文章。研究选择和数据提取：选择12项研究，其中10项是病例对照研究或基于人群的研究。在研究PPI使用与艰难梭菌感染之间的关联的4项研究中，有3项发现呈正相关。这些研究的许多参与者在感染前没有抗生素暴露史。三项研究发现，社区获得性肺炎与PPI治疗之间存在显着关系，且可能存在剂量反应关系。两项研究发现，使用PPI可能增加骨折风险，并可能存在剂量反应关系。三分之二的研究发现维生素B_（12）缺乏与PPI治疗之间存在关联。数据综合：大多数研究发现PPI的使用与艰难梭菌感染，肺炎，骨折和维生素B_（12）的发展之间存在显着关联。 ）缺陷，根据PPI的作用机理，所有这些都是合理的。由于缺乏随机对照试验，。这些不良反应的根本原因尚有争议。结论：使用PPI与艰难梭菌感染，肺炎，骨折和维生素B_（12）缺乏之间的因果关系尚未确定。需要精心设计的前瞻性随机研究以确认长期使用PPI是否存在风险。在获得此类研究结果之前，应定期检查个别患者是否适当使用PPI，因为这些并发症给老年人带来的后果可能是灾难性的。

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