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Volume 6, Issue 7(Suppl) J Gastrointest Dig Syst 2016
ISSN: 2161-069X JGDS, an open access journal
Page 26
Notes:
Gastro Congress 2016
October 24-25, 2016
conferenceseries.com
October 24-25, 2016 Valencia, Spain
9th Euro Global
Gastroenterology Conference
Acid-suppressive medications and infections: Pro and contra
Alexander Fisher
The Canberra Hospital- Australian National University Medical School, Australia
This review summarizes the benefits, risks and appropriate use of acid-suppressing drugs (ASDs), proton pump inhibitors
(PPIs) and histamine-2 receptor antagonists (H2RAs), particularly in the elderly, advocating a rationale balanced and
individualized approach aimed to minimize any serious adverse consequences. It focuses on current controversies on the
potential of ASDs to contribute to infections - bacterial, parasitic, fungal, protozoan and viral, comprehensively and critically
discusses the growing body of observational literature linking ASD use to a variety of enteric, respiratory, skin and systemic
infectious diseases and complications (Clostridium difficile diarrhoea, pneumonia, spontaneous bacterial peritonitis,
septicaemia and other). The pathogenic mechanisms of ASD-associated infections (related and unrelated to the inhibition of
gastric acid secretion, alterations of the gut microbiome and immunity), agent-specific side effects and drug-drug interactions
are also described. However, accumulating data on the complexity of ASD effects involving important defense systems and
resulting in dysbiosis and increased risk for infections, particularly in the elderly, should not invalidate their use as long as it
is evidence based. Both probiotics use and correcting vitamin D status may have a significant protective effect decreasing the
incidence of ASD- associated infections. The importance of individualized therapy and caution in ASD use considering the
possible spectrum of adverse events, the balance of benefits and potential harms, factors that may predispose to and actions
that may prevent/attenuate adverse effects is evident. A six step practical algorithm for ASD therapy based on the best available
evidence is recommended.
Biography
Alexander Fisher, MBBS, PhD, Doc Med. Sci, FRACP, is a Senior Consultant, Department of Geriatric Medicine, Australian National University Medical School and
The Canberra Hospital.
Alexander Fisher, J Gastrointest Dig Syst 2016, 6:7(Suppl)