The popular class of antacids that includes Aciphex, Dexilant, Nexium, Prevacid, Prilosec, and Protonix increases the risk of C. difficile infection and bone fracture, new studies find. The drugs all are proton pump inhibitors (PPIs), the most powerful class of antacid drugs. It's the third highest-selling class of drugs in the U.S. Each year, doctors write 113.4 million prescriptions for the drugs. Two, Prevacid and Prilosec, are available without prescription.
PPIs are supposed to be used only for serious conditions, but often they are taken for simple heartburn. Moreover, doctors tend to overprescribe PPIs for hospitalized patients, according to a series of articles in the May 10 issue of Archives of Internal Medicine. Perhaps the scariest PPI risk is serious infection with C. difficile bacteria, a hard-to-cure infection that causes severe diarrhea. Stomach acid does a great job of keeping C. diff down. PPIs, however, keep stomach acid below the levels that protect against this bad bug. Hospital patients treated for C. diff infections are 42% more likely to have their C. diff infection come back if they take PPIs. About 60% of U.S. hospital patients get antacids. This translates into tens of thousands of extra C. diff cases each year.
PPIs Increase Fractures
Data from more than 130,000 women enrolled in the Women's Health Initiative who reported current PPI use were 47% more likely to have had a spine fracture, 26% more likely to have a forearm or wrist fracture, and 25% more likely to have any kind of fracture. The benefits of PPIs may not justify their risks for many people, suggests certain researchers. "PPIs have been over-prescribed," one researcher notes in an editorial accompanying the studies. "Between 53% and 69% of PPI prescriptions are for inappropriate indications." Moreover, the researcher suggests that for most patients, the PPI risks outweigh their benefits. He recommends that doctors offer other treatments for heartburn, including non-drug treatments such as stress reduction, weight loss, and smoking cessation. When PPIs are used, Katz advises doctors to use shorter courses and lower doses when possible.
Bonnie - I have been screaming from the mountaintops over the gross misuse of PPIs over the last 10-15 years, especially in colicky babies and and infants that spit up. There are proven nutritional methods that can address reflux without medication.