Risk for patients contracting pneumonia increases threefold when treated with pantoprazole

According to researchers at Wake Forest University School of Medicine, a popular stomach-acid reducer used to prevent stress ulcers in critically ill patients needing breathing machine support increases the risk of those patients contracting pneumonia threefold.

Hospital-acquired pneumonia is the leading cause of infection-related deaths in critically ill patients. It increases hospital stays by an average of seven to nine days, cost of care, and the risk of other complications.

"As best we can tell, patients who develop hospital-acquired pneumonia or ventilator-acquired pneumonia have about a 20 to 30 percent chance of dying from that pneumonia," said senior study author David L. Bowton, M.D., professor and head of the Section on Critical Care in the Department of Anesthesiology. "It's a significant event."

The study, published in a recent issue of CHEST, compared treatment with two drugs that decrease stomach acid: ranitidine, marketed under the name ZantacTM, and pantoprazole, marketed under the name ProtonixTM or PrilosecTM.

Both drugs decrease stomach acid, but the newer pantoprazole is considered more powerful and has become the drug of choice in many hospitals.

However, in the analysis of 834 patient charts, the researchers found that hospitalized cardiothoracic surgery patients treated with pantoprazole were three times more likely to develop pneumonia.

"We conducted this study, in part, because we thought we were seeing more pneumonias than we were used to having," said study co-author Marc G. Reichert, Pharm.D., pharmacy coordinator for surgery at Wake Forest University Baptist Medical Center.

Both acid-reducing drugs can make the stomach a more hospitable place for bacteria to colonize. Patients on breathing machines sometimes develop pneumonia when stomach secretions reflux into the lungs.

Current treatment guidelines to prevent pneumonia recommend raising the head of the bed for patients on breathing machines, which reduces the risk of stomach secretions getting into the lungs.

But the study's findings suggest some other steps could keep critically ill patients from developing ventilator-associated pneumonia.

Doctors should consider whether an acid reducer is needed at all, Bowton said. The occurrence of stress ulcer bleeding has gone down in recent years, perhaps because patients with breathing tubes are fed earlier, and food in the stomach may neutralize or reduce the effects of stomach acid.

Bowton added that in cases where an acid reducer is needed, ranitidine is recommended, given the apparent decreased risk in developing pneumonia.

Doctors should stop using the drug as soon as the risk of bleeding passes - once the patient is off the breathing machine and eating, either on his/her own or through a feeding tube.

Risk factors for pneumonia

by Groshan Fabiola

There are a lot of risk factors when it comes to pneumonia. These factors mainly apply to adults. Some of the most common risk factors for pneumonia are: environmental pollutants, alcohol, drugs, serious lung problems or a weakened immune system.

Environmental pollutants and smoke are some of the most important risk factors in pneumonia. If a person smokes more than one pack of cigarettes a day he/ she risks to develop pneumonia much more than a person who does not smoke. Moreover, even if you are not a smoker, but are exposed daily to cigarette smoke, then you are at risk of developing pneumonia as much as a person who smokes is. If you quit smoking, then the risk of developing pneumonia is reduced very much, but the entire benefits of quitting take almost ten years until they are realized. Besides cigarette smoke, industrial smoke, toxic fumes or any other pollutants can damage cilia as well, putting you at risk of developing pneumonia.

Alcohol and drugs, either combined or used separately are also a very big risk factor in pneumonia cases. These are substances that act like sedatives, thus diminishing your reflexes that trigger sneezing and coughing. Furthermore, alcohol intercedes with the actions of your white blood cells, that play the role of destroying bacteria. So the quantity of alcohol you drink is highly related with developing pneumonia or any other infectious disease. People that used drugs intravenously are also very much at risk of developing pneumonia because they can suffer from an infection at the site of the injection, infections that then can spread through your blood stream.

Dormitory conditions, believe it or not, can also be risk factors for pneumonia. Studies have shown that students or recruits are more likely to develop pneumonia than a normal person. However, studies have also shown that these people are more likely to develop a milder pneumonia and they are at lower risk of developing a more serious pneumonia type.

Your immune system also plays a very important risk in pneumonia cases. People that have an impaired immune system are very susceptible to pneumonia. Any conditions that somehow compromises your immune system makes you very vulnerable to pneumonia.

About the Author
You can find great content regarding pneumonia symptoms, pneumonia vaccine and many moreby visiting http://www.pneumonia-center.com/

Pneumonia and its causes, risk factors and diagnosis

by Groshan Fabiola

There are are mechanisms to protect your lungs from infection at each stage of the respiratory stage, but because you are very much exposed to viruses and bacteria sometimes these mechanisms fail in protect your respiratory system and you develop pneumonia. The infectious agents are attacked by white blood cells and all the process determins inflammation and difficult breathing.

Varius types of pneumonia include: Community-acquired pneumonia that is aquired at school, work or the gym which may be mistaken with the acute eosinophilic pneumonia developed by soldiers. Nosocomial pneumonia which occurs in hospitalized people, especially in those who are on a mechanical ventilator, are in the intensive care unit or have a compromised immune system. This type is severe especially in people with chronic obstructive pulmonary diseases or HIV/AIDS.

Aspiration pneumonia which has been described in a brain injury or other condition affects your normal gag reflex, when the content of the stomach is inhaled in your lungs after vomiting. Opportunistic pneumonia appears in people with compromised immune systems, with AIDS, sickle cell disease, other conditions that impair the immune system. For example, P. carinii pneumonia that almost never occurs inhealthy people.

Risk factors Persons aged 65 and older, very young children, persons with immune deficiency diseases as HIV/AIDS and chronic illnesses, removed spleen, impaired immune system. It has been proved that smoke and abuse alcohol are dangerous too. People who require mechanical ventilation are particularly at risk because the breathing tube, patients hospitalized in an intensive care unit, exposion to certain chemicals or pollutants, toxic fumes. Exposion to fungus as: Coccidioidomycosis, found in the US, Southern California and the desert Southwest or histoplasmosis moslty found in Ohio and Mississippi River valleys.

When to seek medical advice if you experience shortness of breath, chest pain that fluctuates, cough, an unexplained fever with chills and sweats. If you have heart failure or lung ailments, pneumonia can prove fatal in as little as 24 hours.

Screening and diagnosis After your doctor exams you and diagnosis the pneumonia you will be sent to chest X-rays and if the image is not clear enough then you may have a more sophisticated imaging test known as a computerized tomography (CT) scan, which takes a series of computer-directed X-rays. Blood tests are necesary and sometimes the examination of your phlegm.

Complications

In young and healthy people your pneumonia is treated with succes, but with the age and if your health is deteriorated: heart failure or lung ailments pneumonia is harder to cure. You may develop the following complications: Bacteremia if the infection invades your bloodstream this way it spreads quickly to the other organs, interferes with your ability to breathe because inflammates your lungs. Pleural effusion occurs when sometimes fluid accumulates between the thin, transparent membrane (pleura) covering your lungs and the chest wall.

About the Author
You can find great content regarding pneumonia causes, pneumonia symptoms and many more by visiting http://www.pneumonia-center.com/