Case | Age yrs | Sex | Medical history | Indication for PPI use | PPI | DDDs n | Time to CAP days | Causative organism | PSI score | Admission to ICU |
1 | 60 | F | Resection of middle lobe because of recurrent pneumonia caused by bronchiectasis (5 yrs before CAP), primary biliary cirrhosis | Gastric protection during NSAID use for arthrosis in hands | O | 1 | 2 | H. influenzae | 60 | No |
2 | 72 | M | Hypertension, COPD (GOLD stage I) | Gastric protection during NSAID use for lower back pain | O | 1 | 10 | E. coli | 102 | No |
3 | 80 | M | Aorta valve replacement after stenosis (6 yrs before CAP), no further cardiac pathology | Gastric protection during NSAID use for lower back pain | O | 2 | 13 | Parainfluenza virus | 90 | No |
4 | 18 | M | Gastric discomfort and air regurgitation | O | 1 | 20 | S. pneumoniae | 58 | No | |
5 | 34 | F | Deep venous thrombosis (1 month before CAP) | Gastric protection during NSAID use for painful leg, previous use of NSAID caused discomfort | O | 1 | 25 | Unidentified | 34 | Yes |
6 | 65 | F | COPD, transient ischaemic attack, breast carcinoma (curative treatment 3 yrs before CAP) | Gastric protection during use of NSAID, prednisone, aspirin and dipyridamole | P | 1 | 8 | H. influenzae | 105 | Yes |
7 | 70 | M | Pneumonia, hypertension, hypercholesterolaemia | Xyphoid pain radiating to lungs, general practitioner assumed GORD, but it might have been CAP | O | 1 | 1 | Unidentified | 60 | No |
8 | 32 | M | Gastric protection during NSAID use for painful shoulder | O | 1 | 8 | S. milleri | 57 | No | |
9 | 41 | F | Uterus myomatosis | Stomach ache, patient always reported to experience stomach ache before fever | P | 1 | 1 | L. pneumophila | 51 | No |
10 | 83 | F | Aorta valve stenosis, mitral valve insufficiency, hypertension, COPD, CHF | Stomach ache during H. pylori infection | P | 1 | 29 | S. pneumoniae | 83 | No |
11 | 60 | F | Alcohol abuse, DM II | Therapy for bleeding duodenal ulcer | O/P# | 1 | 16 | Unidentified | 80 | Yes |
12 | 62 | M | DM II, hypertension, COPD with emphysema, CHF, pulmonary hypertension | Therapy for peptic ulcer during NSAID use | R | 1 | 22 | S. pneumoniae | 122 | Yes |
DDD: daily defined dose; CAP: community-acquired pneumonia; PSI: Pneumonia Severity Index; ICU: intensive care unit; F: female; M: male; COPD: chronic obstructive pulmonary disease; GOLD: Global Initiative for Chronic Obstructive Lung Disease; CHF: congestive heart failure; DM II: diabetes mellitus, type II; NSAID: nonsteroidal anti-inflammatory drug; GORD: gastro-oesophageal reflux disease; O: omeprazole; P: pantoprazole; R: rabeprazole; H. pylori: Helicobacter pylori; H. influenzae: Haemophilus influenzae; E. coli: Escherichia coli; S. pneumoniae: Streptococcus pneumoniae; S. milleri: Streptococcus milleri; L. pneumophila; Legionella pneumophila. #: this patient received an additional prescription for 40 mg pantoprazole, daily for 7 days after the omeprazole prescription was issued, which was 9 days before CAP diagnosis; based on the prescribed daily dose, the prescription for omeprazole could have lasted until 1 day before CAP diagnosis.