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Multicenter Study
. 2020 Oct;20(7):1323-1331.
doi: 10.1016/j.pan.2020.08.009. Epub 2020 Aug 22.

Acid suppression therapy, gastrointestinal bleeding and infection in acute pancreatitis - An international cohort study

Alexandra Demcsák  1 Alexandra Soós  2 Lilla Kincses  1 Ines Capunge  3 Georgi Minkov  4 Mila Kovacheva-Slavova  5 Radislav Nakov  5 Dong Wu  6 Wei Huang  7 Qing Xia  7 Lihui Deng  7 Marcus Hollenbach  8 Alexander Schneider  9 Michael Hirth  10 Orestis Ioannidis  11 Áron Vincze  12 Judit Bajor  12 Patrícia Sarlós  12 László Czakó  13 Dóra Illés  13 Ferenc Izbéki  14 László Gajdán  14 Mária Papp  15 József Hamvas  16 Márta Varga  17 Péter Kanizsai  18 Ernő Bóna  18 Alexandra Mikó  2 Szilárd Váncsa  2 Márk Félix Juhász  2 Klementina Ocskay  2 Erika Darvasi  13 Emőke Miklós  2 Bálint Erőss  2 Andrea Szentesi  19 Andrea Párniczky  20 Riccardo Casadei  21 Claudio Ricci  21 Carlo Ingaldi  21 Laura Mastrangelo  22 Elio Jovine  23 Vincenzo Cennamo  24 Marco V Marino  25 Giedrius Barauskas  26 Povilas Ignatavicius  26 Mario Pelaez-Luna  27 Andrea Soriano Rios  27 Svetlana Turcan  28 Eugen Tcaciuc  28 Ewa Małecka-Panas  29 Hubert Zatorski  29 Vitor Nunes  30 Antonio Gomes  30 Tiago Cúrdia Gonçalves  31 Marta Freitas  31 Júlio Constantino  32 Milene Sá  32 Jorge Pereira  32 Bogdan Mateescu  33 Gabriel Constantinescu  34 Vasile Sandru  35 Ionut Negoi  36 Cezar Ciubotaru  36 Valentina Negoita  36 Stefania Bunduc  37 Cristian Gheorghe  38 Sorin Barbu  39 Alina Tantau  40 Marcel Tantau  41 Eugen Dumitru  42 Andra Iulia Suceveanu  42 Cristina Tocia  42 Adriana Gherbon  43 Andrey Litvin  44 Natalia Shirinskaya  45 Yliya Rabotyagova  46 Mihailo Bezmarevic  47 Péter Jenő Hegyi  48 Jimin Han  49 Juan Armando Rodriguez-Oballe  50 Isabel Miguel Salas  50 Eva Pijoan Comas  50 Daniel de la Iglesia Garcia  51 Andrea Jardi Cuadrado  51 Adriano Quiroga Castiñeira  51 Yu-Ting Chang  52 Ming-Chu Chang  52 Ali Kchaou  53 Ahmed Tlili  53 Sabite Kacar  54 Volkan Gökbulut  54 Deniz Duman  55 Haluk Tarik Kani  55 Engin Altintas  56 Serge Chooklin  57 Serhii Chuklin  57 Amir Gougol  58 George Papachristou  58 Péter Hegyi  59
Affiliations
Free article
Multicenter Study

Acid suppression therapy, gastrointestinal bleeding and infection in acute pancreatitis - An international cohort study

Alexandra Demcsák et al. Pancreatology. 2020 Oct.
Free article

Abstract

Background: Acid suppressing drugs (ASD) are generally used in acute pancreatitis (AP); however, large cohorts are not available to understand their efficiency and safety. Therefore, our aims were to evaluate the association between the administration of ASDs, the outcome of AP, the frequency of gastrointestinal (GI) bleeding and GI infection in patients with AP.

Methods: We initiated an international survey and performed retrospective data analysis on AP patients hospitalized between January 2013 and December 2018.

Results: Data of 17,422 adult patients with AP were collected from 59 centers of 23 countries. We found that 23.3% of patients received ASDs before and 86.6% during the course of AP. ASDs were prescribed to 57.6% of patients at discharge. ASD administration was associated with more severe AP and higher mortality. GI bleeding was reported in 4.7% of patients, and it was associated with pancreatitis severity, mortality and ASD therapy. Stool culture test was performed in 6.3% of the patients with 28.4% positive results. Clostridium difficile was the cause of GI infection in 60.5% of cases. Among the patients with GI infections, 28.9% received ASDs, whereas 24.1% were without any acid suppression treatment. GI infection was associated with more severe pancreatitis and higher mortality.

Conclusions: Although ASD therapy is widely used, it is unlikely to have beneficial effects either on the outcome of AP or on the prevention of GI bleeding during AP. Therefore, ASD therapy should be substantially decreased in the therapeutic management of AP.

Keywords: Acid suppressing drug; Acute pancreatitis; Gastrointestinal bleeding; Gastrointestinal infection; Proton pump inhibitor.

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Conflict of interest statement

Declaration of competing interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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