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COMMENTS & OPINIONS
Acid Suppression Not the Only Culprit of Community-Acquired Pneumonia—Reply
Sinem Ezgi Gulmez, MD, PhD;
Jesper Hallas, DMSC;
Henrik Frederiksen, MD, PhD
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In reply
We are pleased that our study1 has generated interest, and we appreciate the opportunity to respond to the queries.
Kerman and Barkin have pointed out GERD and other risk factors for CAP. Gastroesophageal reflux disease itself might explain an excess in the incidence of CAP among proton pump inhibitor users.2 Reflux is associated with some airway symptoms, such as cough and uncontrolled asthma, but there is little evidence to support a strong association between reflux disease and CAP.3-4 Second, only a minority of proton pump inhibitor users in our setting had verified reflux.5 Finally, we also found an association among persons who took proton pump inhibitors for indications other than reflux (eg, peptic ulcer). Therefore, a strong confounding by reflux is unlikely.
In our study, COPD was included as a confounding factor as crude marker of . . . [Full Text of this Article]
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RELATED ARTICLE
Use of Proton Pump Inhibitors and the Risk of Community-Acquired Pneumonia: A Population-Based Case-Control Study
Sinem Ezgi Gulmez, Anette Holm, Henrik Frederiksen, Thøger Gorm Jensen, Court Pedersen, and Jesper Hallas
Arch Intern Med. 2007;167(9):950-955.
ABSTRACT
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RELATED LETTER
Acid Suppression Not the Only Culprit of Community-Acquired Pneumonia
David Kerman and Jamie S. Barkin
Arch Intern Med. 2008;168(10):1118-1119.
EXTRACT
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