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European Journal of Epidemiology

, Volume 31, Issue 10, pp 1057–1063

First Online: 10 March 2016Received: 02 November 2015Accepted: 01 March 2016DOI: 10.1007-s10654-016-0136-8

Cite this article as: Hassing, RJ., Verbon, A., de Visser, H. et al. Eur J Epidemiol 2016 31: 1057. doi:10.1007-s10654-016-0136-8


An association between proton pump inhibitor PPI therapy and bacterial gastroenteritis has been suggested as well as contradicted. The aim of this study was to examine the association between the use of PPIs and occurrence of bacterial gastroenteritis in the prospective Rotterdam Study. The Rotterdam Study is a population-based cohort study among 14,926 subjects aged 45 years and older with up to 24 years of follow-up. Analyses were performed with a generalized estimating equations method in participants who handed-in a diagnostic stool sample. Furthermore, a nested case–control analysis was performed using the total cohort as a reference group. A bacterial microorganism was isolated in 125 samples, whereas 1174 samples were culture negative. In the generalized estimating equations analysis, we found that participants with a bacterial gastroenteritis were more likely than controls to be current users of PPIs adjusted OR 1.94; 95 % CI 1.15–3.25. Different sensitivity analyses did not change this result. A considerably higher effect was observed adjusted OR 6.14; 95 % CI 3.81–9.91, using the total cohort as a reference in a nested case–control analysis. Current PPI therapy is associated with an increased risk of bacterial gastroenteritis. However, by reducing the risk of selection and information bias in our study design, we demonstrated that the effect is lower than previously assumed.

KeywordsGastroenteritis Proton pump inhibitor Campylobacter Salmonella Cohort study  Download fulltext PDF

Author: Robert-Jan Hassing - Annelies Verbon - Herman de Visser - Albert Hofman - Bruno H. Stricker


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