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Millions of patients are being unnecessarily treated with expensive indigestion drugs that can cause serious side-effects, researchers warn.
The prescription drugs - proton pump inhibitors - stop the backflow of acid from the stomach and are used to treat ulcers and to prevent heartburn and gastric reflux.
But an analysis of research into the side-effects of PPIs has found between half and two-thirds of such prescriptions are 'inappropriate'.
PPIs increase the risk of pneumonia, osteoporosis, broken bones, kidney problems and infection with C.difficile, the superbug that afflicts thousands of older hospital patients every year.
The report found that while PPIs were effective in several conditions, there was evidence they are excessively used to treat indigestion when other prescription medicines costing half as much would work just as well, without such severe side-effects.
There were 36million prescriptions written for PPIs in the UK last year - a threefold rise since2000.
Doctors have previously warned the NHS is spending £100million unnecessarily each year over-treating indigestion patients with PPIs - around one-quarter of the total expenditure on the drugs.
A report in the British Medical Journal found overuse of the drugs flouted NHS guidelines, because doctors were reaching for the 'top weapon in the armoury' to treat even mild cases of indigestion.
Dr Mitchell Katz, of the San Francisco Department of Public Health, writing in the journal Archives of Internal Medicine, said overuse of PPIs was a major problem.
He said: 'That proton pump inhibitors relieve dyspepsia is without question but at what cost - and I do not mean financial.'
The U.S. report looked at a series of studies highlighting the side-effects of PPIs.
An eight-year study involving 162,000 women aged 50 to 79 showed the drugs raised the risk of fractures, particularly in the spine and wrist.
It is thought that when PPIs reduce acid secretion by the stomach, it results in less calcium being absorbed by the body, leading to weakened bones. An analysis of 100,000 patients discharged from hospitals over five years found PPIs caused a 74 per cent increase in infection with C.diff.
Another study looked at 1,200 patients being treated for C.diff and found a 42 per cent increased risk of recurrence if PPIs were being used.
With C.diff, doctors say that when PPIs reduce stomach acid it allows the superbug to survive more easily. The bug produces toxins which damage the bowel's lining, resulting in severe diarrhoea.
It is usually spread by the hands of healthcare staff and via contaminated surfaces.
Other research has found that PPIs are linked with higher levels of bacterial pneumonia.
Archives editor Dr Rita Redberg said: 'Harm will result if these commonly used medications are prescribed for conditions for which there is no benefit, such as non-ulcer dyspepsia.'
