Associations between antibiotics, proton pump inhibitors, NSAIDs and liver abscess

IF 4 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-10-16 DOI:10.1016/j.jiph.2025.103012

Hon-Yen Wu , Chun-Ru Hsu , Ping-Hsiu Tsai , Mei-Ju Ko , Yu-Tsung Huang , Chun-Hsing Liao

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引用次数: 0

Abstract

Objective

Liver abscess (LA) caused by Klebsiella pneumoniae is endemic in Taiwan. This study aimed to clarify the associations between antibiotics, PPIs, and NSAIDs among patients hospitalized due to LA.

Methods

This population-based, case-control study was conducted using the 2005 Longitudinal Generation Tracking Database of Taiwan’s National Health Insurance, comprising 2 million insured individuals from 2000 to 2021. Individuals without LA were matched to adult LA patients by age and sex using propensity score matching (PSM). Exposure to antibiotics, PPIs, and NSAIDs within one year prior to diagnosis was assessed. Logistic regression analysis was used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs).

Results

After PSM, the data of 10,335 patients with liver abscess and 20,670 controls were analyzed. Within 7 days prior to hospitalization, univariate analysis showed significantly higher ORs of LA associated with 2nd/3rd generation cephalosporins (OR 181.91, 95 % CI 58.5–566.1), 1st generation cephalosporins (OR 18.5, 95 % CI 9.6–35.5), NSAIDs (OR 17.0, 95 % CI 11.7–24.8), amoxicillin/ampicillin with beta-lactamase inhibitors (OR 15.0, 95 % CI 7.5–30.0), PPIs (OR 9.5, 95 % CI 6.4–14.0), and fluoroquinolones (OR 9.2, 95 % CI 5.6–15.1). Multivariable logistic regression revealed that associations between LA and medication use persisted for NSAIDs, 2nd/3rd generation cephalosporins, and amoxicillin/ampicillin with beta-lactamase inhibitors up to one year prior to hospitalization.

Conclusion

PPIs, NSAIDs, and some antibiotics are significantly associated with increased risk of LA, necessitating cautious medication use.

查看原文本刊更多论文

抗生素、质子泵抑制剂、非甾体抗炎药与肝脓肿的关系

目的肺炎克雷伯菌引起的肝脓肿是台湾地区的一种地方性疾病。本研究旨在阐明因LA住院的患者中抗生素、质子泵抑制剂和非甾体抗炎药之间的关系。方法本研究以人群为基础，采用2005年台湾全民健保纵向世代追踪数据库，包含2000年至2021年200万参保人员。使用倾向评分匹配（PSM）将未发生LA的个体与成年LA患者按年龄和性别进行匹配。评估诊断前一年内抗生素、PPIs和非甾体抗炎药的暴露情况。采用Logistic回归分析估计比值比（ORs）和95% %置信区间（CIs）。结果对肝脓肿患者10335例和对照组20670例进行了PSM分析。住院前7天内，单因素分析显示，与第二/第三代头孢菌素（OR 181.91, 95 % CI 58.5-566.1）、第一代头孢菌素（OR 18.5, 95 % CI 9.6-35.5）、非甾体抗炎药（OR 17.0, 95 % CI 11.7-24.8）、阿莫西林/氨苄西林联合β -内酰胺酶抑制剂（OR 15.0, 95 % CI 7.5-30.0）、PPIs （OR 9.5, 95 % CI 6.4-14.0）和氟喹诺酮类药物（OR 9.2, 95 % CI 5.6-15.1）相关的LA OR显著升高。多变量logistic回归显示，非甾体抗炎药、第二/第三代头孢菌素和阿莫西林/氨苄西林联合β -内酰胺酶抑制剂的LA与用药之间的关联持续到住院前一年。结论质子泵抑制剂、非甾体抗炎药和一些抗生素与LA风险增加显著相关，用药应谨慎。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.