Protonix May Increase Risk of Pneumonia Over Zantac for Critically Ill: Study

New research suggests that side effects of Protonix, a stomach acid reducer, may triple the risk of pneumonia for critically ill patients when compared to the competing medication, Zantac.

Researchers from the Wake Forest School of Medicine in North Carolina published the results of the study last month in the medical journal Chest. The study found that both Protonix (pantoprazole) and Zantac (ranitidine), turn the stomach into a more habitable place for bacteria to grow due to their reduction of the stomach’s acid. However, Protonix, which is used more often in most hospitals, carries an increased risk of hospital-acquired pneumonia in cardiothoracic surgery patients on a breathing machine.

Hospital-acquired pneumonia is a common risk for critically ill patients, particularly those on ventilators. Contraction of pneumonia puts critically ill patients at a 20 to 30 percent risk of death, and can increase a patient’s hospital stay by seven to nine days, potentially exposing them to other complications. Pneumonia usually occurs because stomach secretions have entered the lungs.

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Scientists looked at 834 patient charts of hospitalized cardiothoracic surgery patients, and found that those treated with pantoprazole (Protonix) were three times more likely to contract hospital-acquired pneumonia than those given ranitidine (Zantac). The researchers found that the earlier the patient could be removed from stomach acid reducer medication, the less likely they were to contract pneumonia.

Doctors commonly treat patients on ventilators for the risk of stress ulcers, which can be increased significantly while someone is on a ventilator. But researchers said that stress ulcers may not be as much of a concern for ventilator patients as it used to be, because hospitals now feed patients on breathing tubes earlier, and the food in the stomach can neutralize or reduce the effects of stomach acid.

Researchers suggested that doctors elevate the heads of patients on ventilators, to reduce the chances of stomach secretions invading the lungs, and also suggested that, when stomach acid reducers are needed, doctors consider the less-powerful Zantac.


  • lindaOctober 21, 2014 at 11:31 pm

    Same here. I've had a cough and was diagnosed with walking pneumonia. I am coming off of this ppi. The GI doctor didn't give my complaint any creditibility. I'm finding me a new doctor.

  • FredMay 19, 2010 at 9:23 pm

    I have been on many acid reducing medication since 1986. I was put on Protonix in March, 2010 and have developed a persistent cough since taking it. This past month I was diagnosed with "walking pneumonia", which I have never, ever had before. Maybe your article has some truth to it. Who knows?!

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