In a new study, researchers found that common heartburn meds may foster the growth of antibiotic-resistant bacteria in the gut.
They found people who use acid-suppressing medications—particularly proton pump inhibitors (PPIs)—are more likely to have antibiotic-resistant bacteria in the gut.
The findings do not prove that PPIs—which include popular brands such as Prilosec (omeprazole), Prevacid (lansoprazole) and Nexium (esomeprazole)—are the cause.
But they raise safety questions about the popular prescription and over-the-counter medicines.
The research was conducted by a team at McGill University.
PPIs work by blocking the enzyme system that creates stomach acid.
They are commonly prescribed for gastroesophageal reflux disease (GERD), in which stomach acid chronically escapes into the esophagus (the tube connecting the mouth and stomach).
Previous studies have linked long-term PPI use to increased risks of heart and kidney disease, stomach cancer and certain infections—as well as deficiencies in calcium, magnesium and vitamin B12.
In the study, the team reviewed 12 published studies that involved more than 22,300 people in all—about 8,500 of whom used acid-suppressing drugs.
That meant PPIs or H2 blockers, which include medications like Tagamet (cimetidine), Pepcid (famotidine) and Zantac (ranitidine).
They found overall, people on the medications were 74% more likely to harbor bacteria that were resistant to multiple antibiotics. The risk appeared largely confined to PPIs.
The studies looked only at whether people carried antibiotic-resistant bacteria—not whether the bugs caused any health issues.
But harboring those bacteria may put people at increased risk of antibiotic-resistant infections—and it perpetuates the broader problem of antibiotic resistance.
In addition, the link was stronger among hospital patients on PPIs—who may be given the drugs to prevent stress ulcers—than in everyday users.
Because stopping a PPI can cause temporary “rebound” acid reflux, people can end up thinking they need to continue the medication.
Even in cases of true GERD, people can often come off their PPI after damaged tissue in the esophagus heals.
The findings reinforce the importance of careful consideration in deciding when to use acid-suppressive medications.
One author of the study is Dr. Todd Lee, an associate professor of medicine at McGill University in Montreal.
The study is published in JAMA Internal Medicine.
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