Recent treatment with H2 antagonists and antibiotics and gastric surgery as risk factors for salmonella infection

Abstract

Experimental evidence shows that gastric acid protects against enteric infections,1,2 and patients who have had gastric surgery seem to be more susceptible to salmonella infection.3,4 Whether H2 antagonists are also associated with salmonella infection is not known, although diarrhoea is a recognised side effect. Statutory notifications of salmonella infection have increased in recent years and the use of H2 antagonists has become widespread, suggesting that suppression of acid by these drugs may have been contributory. We conducted a case-control study to assess whether H2 antagonists are associated with salmonella infection. From March 1990 to September 1992, 218 notified cases of salmonella infection, confirmed by faecal culture, occurred in people aged >=45 in the Nottingham area. Thirty cases were excluded because the …