PPIs in cirrhosis: more evidences for a careful prescription!

We thank Yu-Jen Chen 1 and Andrew M. Moon 2 for their interest in our study 3 . Their comments are extremely stimulating and appropriate. They both pointed out that some variables, including infections, smoking, obesity, NSAID use and vascular diseases have not been taken into account as potential risk factors for mortality in our multivariate analysis. As far as the relationship between PPIs use and infections, our group has already demonstrated that PPIs use is an independent risk factor for the development of infections in cirrhotic patients 4 , which is in turn associated to higher mortality 5 . Following the suggestion of A. Moon letter, we examined the causes of death stratified according to the PPIs use and we confirm that the deaths due to an infection were more frequent in PPIs users (49% vs 19%, p<0.01). This article is protected by copyright. All rights reserved.