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Proton pump inhibitors are associated with hypersensitivity reactions to drugs in hospitalized patients: A nested case-control in a retrospective cohort study

机译：质子泵抑制剂与住院患者对药物的超敏反应有关：一项回顾性队列研究中的嵌套病例对照

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Background: Previous research has shown that gastric acid suppression by antacid drugs can promote allergic reactions to acid-labile food proteins. No data are available about whether antacid drugs can promote drug hypersensitivity reactions. The most potent and longer lasting inhibition of gastric secretion is provided by proton pump inhibitors (PPIs). We hypothesized that gastric acid suppression by proton pump inhibitors could be causative of drug hypersensitivity reactions during hospitalization. Objective: To estimate the risk of developing drug hypersensitivity reactions during the hospitalization of patients treated with proton pump inhibitors, and other associated factors. Methods: A nested case-control in a retrospective cohort study of hospitalized patients from September 2008 to December 2010 (70 771 admissions) was conducted using the registry of cases of interconsultations to the Allergy Department (161 confirmed cases of drug hypersensitivity reactions). A total of 318 controls were matched by first drug suspected in the hypersensitivity reaction, time of admission, age, gender and hospitalization wards. Results: The relative risk of drug hypersensitivity reaction occurrence during hospitalization of patients treated with PPIs compared with those not treated in the period of study was significant (RR: 3.97; 95% CI: 1.97-8.29). After controlling for confounders in the nested case-control cohort, the use of PPIs persists as a predisposing factor (OR: 4.35; 95% CI: 2-9.45). Personal history of drug allergy and a long hospitalization time were other predisposing factors of drug hypersensitivity reactions (DHRs). The hazard that a DHR has occurred during PPI treatment was 3.7% per day. The hazard for immediate or accelerated reactions was 1.706 (P = 0.003) times that of delayed reactions. Conclusion and Clinical Relevance: In hospitalized patients, the use of proton pump inhibitors was associated with a significant increase risk of drug hypersensitivity reactions along with a personal history of drug allergies and long hospitalization time. ? 2012 Blackwell Publishing Ltd.
机译：背景：先前的研究表明，抗酸药抑制胃酸可以促进对酸不稳定的食物蛋白的过敏反应。没有有关抗酸药是否能促进药物超敏反应的数据。质子泵抑制剂（PPI）提供了对胃液分泌的最有效，最持久的抑制。我们假设质子泵抑制剂抑制胃酸可能是住院期间药物超敏反应的原因。目的：评估使用质子泵抑制剂和其他相关因素治疗的患者住院期间发生药物超敏反应的风险。方法：对2008年9月至2010年12月期间住院患者（70 771例入院）的一项回顾性队列研究，采用对病例的相互嵌套的病例对照研究，方法是向过敏部门进行病情咨询（确诊为药物过敏反应的病例为161例）。总共318个对照组与超敏反应，入院时间，年龄，性别和住院病房中怀疑的第一种药物相匹配。结果：与研究期间未治疗的患者相比，接受PPI治疗的患者住院期间发生药物超敏反应的相对风险显着（RR：3.97; 95％CI：1.97-8.29）。在控制嵌套病例对照队列中的混杂因素之后，PPI的使用仍然是诱发因素（OR：4.35; 95％CI：2-9.45）。药物过敏的个人病史和较长的住院时间是药物超敏反应（DHR）的其他诱因。 PPI治疗期间发生DHR的危险为每天3.7％。立即或加速反应的危险是延迟反应的危险的1.706倍（P = 0.003）。结论和临床意义：在住院患者中，使用质子泵抑制剂与明显增加的药物超敏反应风险以及个人的药物过敏史和较长的住院时间有关。 ？ 2012布莱克威尔出版有限公司

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