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Clin Infect Dis. 2014 Dec 1;59(11):1554-8. doi: 10.1093/cid/ciu628. Epub 2014 Aug 4.

Association between recent use of proton pump inhibitors and nontyphoid salmonellosis: a nested case-control study.

Author information

Office of Preventive Medicine, Centers for Disease Control, Taipei.
Divisions of Nephrology, Taipei Veterans General Hospital Department of Medicine, Taipei City Hospital Heping Fuyou Branch.
Department of Medicine, Taipei Veterans General Hospital, Yuanshan Branch, Yilan School of Medicine, National Yang-Ming University.
Institutes of Clinical Medicine, School of Medicine, National Yang-Ming University Emergency Department, Taipei Veterans General Hospital.
Institutes of Clinical Medicine, School of Medicine, National Yang-Ming University National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan Township, Miaoli County.
Institutes of Clinical Medicine, School of Medicine, National Yang-Ming University Cheng Hsin General Hospital, Taipei, Taiwan.



The association between proton pump inhibitors (PPIs) and nontyphoid salmonellosis (NTS) continues to be debated. The current study was designed to determine the association between use of oral PPIs and the diagnosis of NTS.


The Taiwan National Health Insurance Research Database from 2000 to 2010 was searched for cases of NTS, defined by the International Classification of Disease, Ninth revision, Clinical Modification. A nested case-control study in hospitalized population was conducted using 4 controls for each case patient (14 736 case patients and 58 944 controls), matched for age, month and year of entry, Charlson comorbidity index score, and well-known predisposing factors for NTS, including autoimmune diseases, acquired immunodeficiency syndrome, diabetes, cirrhosis, transplantation, gastrointestinal operations or diseases, and malignancies.


Persons with NTS had a higher rate of using oral PPIs within the prior year (adjusted odds ratio [OR], 2.09; 95% confidence interval [CI], 1.95-2.24; P < .001). The association was greatest for current PPI use (adjusted OR, 5.39; 95% CI, 4.79-6.06; P < .001). Although use of H2-receptor antagonists (adjusted OR, 1.84; 95% CI, 1.71-1.98), antibiotics (5.21; 4.81-5.64), steroids (3.18; 2.99-3.39), and nonsteroidal anti-inflammatory drugs (2.37; 2.26-2.48) within the 30 days were also associated with NTS, the linkage between PPI use and NTS remained significant in the subgroup without these medications.


The use of oral PPIs was associated with the occurrence of NTS. The risk waned with time after discontinuation.


nontyphoid salmonellosis; proton pump inhibitors; risks

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