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Proton Pump Inhibitors in Children: the Good, the Bad, and the Ugly

Eric A Pasman1,2, Bruce Ong1,3, Claire P Witmer1,2

  • 1Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD, USA.

Current Allergy and Asthma Reports
|June 12, 2020
PubMed

Insights

Proton pump inhibitors (PPIs) are useful for some pediatric conditions but lack evidence for others. Emerging research highlights potential risks, including microbiome disruption and increased infections, necessitating careful consideration of PPI use in children.

Area of Science:

  • Pediatric Gastroenterology
  • Pharmacology
  • Immunology

Background:

  • Proton pump inhibitors (PPIs) are frequently prescribed for pediatric gastrointestinal conditions.
  • Their efficacy and safety profile in children require ongoing evaluation.

Purpose of the Study:

  • To review the evidence supporting or contesting the use of PPIs in children.
  • To update on the known side effects and immune-related effects of PPIs in pediatric populations.

Main Methods:

  • Literature review of recent studies on PPI use in children.
  • Analysis of evidence for efficacy in various pediatric conditions.
  • Examination of reported adverse effects and immunological impacts.

Main Results:

  • PPIs remain indicated for esophagitis and gastritis in children.
  • Evidence does not support PPI use for chronic cough, infantile reflux, asthma, or functional gastrointestinal disorders.
  • Recent studies link PPIs to adverse effects on microbiome diversity, immune function, gastrointestinal infections, bone fractures, and atopic disorders.

Conclusions:

  • PPI prescriptions in children are indicated for select conditions.
  • Multiple side effects and immune effects associated with PPIs have been described.
  • Further research is needed to understand the mechanisms of PPI-induced immune and infectious complications.
Abstract

Keywords:
AllergyChildrenImmunologyProton pump inhibitorSide effects

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