pyogenic liver abscess

Q: Which of the following drugs has shown to cause pyogenic liver abscess?


A) beta-blockers
B) calcium channel blockers
C) proton-pump inhibitors
D) acetaminophen
E) thyroid replacement agents


Answer: C

Treatment with proton pump inhibitors has shown to be associated with increased mortality in patients with pyogenic liver abscess. Proton pump inhibitors increase the gastric pH resulting in impaired defense mechanisms against ingested pathogens. Klebsiella pneumoniae is reported to be the most notorious with overgrowth in the intestine and subsequent liver abscess.


References:

1. Lin HF, Liao KF, Chang CM, et al. Correlation between proton pump inhibitors and risk of pyogenic liver abscess. Eur J Clin Pharmacol 2017; 73:1019.

2. Wang YP, Liu CJ, Chen TJ, Lin YT, Fung CP. Proton pump inhibitor use significantly increases the risk of cryptogenic liver abscess: a population-based study. Aliment Pharmacol Ther. 2015 Jun;41(11):1175-81. doi: 10.1111/apt.13203. Epub 2015 Apr 13.