Proton pump inhibitors are associated with a reduced likelihood for sexually transmitted diseases in women in the emergency department

BACKGROUND: Proton pump inhibitors (PPIs) have been shown in cell culture to kill Trichomonas vaginalis (TV) at lower half maximal inhibitory concentration values than metronidazole (Flagyl), the most common medication used to treat the infection. However, there have been no previous clinical investigations to determine if PPIs are associated with reduced risk for TV. MATERIALS AND METHODS: We examined the records of female patients who received testing in the emergency department for TV, Neisseria gonorrhoea (GC), and Chlamydia trachomatis (CT) between 2010 and 2014 at two academic medical centers to determine if PPI and histamine type 2 receptor antagonist (H2RA) drugs were associated with TV and GC/CT infections. RESULTS: We found that H2RAs were associated with an increased likelihood for TV (odds ratio [OR]: 2.0, P < 0.0001) and GC and/or CT infections (OR: 1.49, P < 0.0001). PPIs were associated with a reduced likelihood for TV (OR: 0.75, P < 0.0001) and GC and/or CT infections (OR: 0.57, P < 0.0001). In patients infected with GC and/or CT, the likelihood of coinfection with TV was reduced in those taking a PPI (OR: 0.64, P = 0.054) and increased in those taking an H2RA (OR: 1.62, P = 0.003). CONCLUSIONS: PPIs are associated with a reduced risk for TV and GC/CT infection.