This retrospective observational study used data from the national Japanese Diagnosis Procedure Combination inpatient database. We identified patients who were admitted to acute-care hospitals with stroke. The outcome was the occurrence of pneumonia assessed using diagnostic codes. We performed propensity score-matched analysis to compare the outcome between proton pump inhibitor (PPI) users and histamine-2 receptor antagonist (H2RA) users.
A total of 77,890 stroke patients were identified, of whom 63,980 were prescribed H2RAs and 13,910 were prescribed PPIs. Overall, 1490 (10.7%) of the patients receiving PPIs and 6401 (10.0%) of the patients receiving H2RAs developed pneumonia after stroke. After propensity score matching, the incidence of pneumonia in PPI users was not different from that in H2RA users (odds ratio: 1.10, 95% confidence interval: .99-1.21).
No significant difference in the incidence of pneumonia was seen between users of PPIs and H2RAs after acute stroke.