A new analysis of observational studies involving nearly 30,000 patients suggests medications that people take for acid reflux and related stomach problems may increase the risk of colonization with multidrug-resistant organisms (MDROs).

In a systematic review and meta-analysis published this week in JAMA Internal Medicine, researchers from the Netherlands found that gastric acid suppressants—mainly proton-pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2Ras)—were associated with a more than 70% increase in the odds of MDRO colonization of the intestinal tract.

The findings do not prove that acid-suppressing medications cause MDRO colonization, but they add to a growing concern that the widely used—and frequently overprescribed—drugs may affect the composition of intestinal bacteria in potentially harmful ways. Gastric acid suppressants are also associated with increased risk of Clostridioides difficile infection, and previous studies have found links with rectal carriage of antibiotic-resistant bacteria.

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Significant association found

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