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Published on: September 22, 2023
Proton pump inhibitors are still overprescribed for hospitalized children
A Arnoux1, M Bailhache2, C Tetard1
1Bordeaux University Hospital, Pediatric department, Pediatric Gastroenterology Unit, France.
Insights
Proton pump inhibitors are frequently prescribed for hospitalized children, but only 35% of prescriptions follow guidelines. Increased awareness of proton pump inhibitor recommendations is needed for pediatricians.
Area of Science:
- Pediatric Gastroenterology
- Pharmacology
- Hospital Medicine
Background:
- Proton pump inhibitor (PPI) use has surged globally.
- Concerns regarding long-term PPI side effects necessitate adherence to prescribing guidelines.
Purpose of the Study:
- To evaluate the adherence of PPI prescriptions to current recommendations in pediatric inpatient units.
- To identify factors influencing PPI prescription compliance in children.
Main Methods:
- A retrospective, observational study was conducted at Bordeaux University Hospital.
- Medical records of 2237 children hospitalized between April 1 and September 30, 2019, were reviewed.
- PPI prescriptions were compared against French and international guidelines.
Main Results:
- Proton pump inhibitors were prescribed to 11% of hospitalized children, primarily for gastroesophageal reflux disease (47%) and peptic ulcer disease prevention (32.7%).
- Overall compliance with recommendations was 34.5%, significantly lower in infants under 1 year (13.5%).
- Compliance was higher for gastroesophageal reflux disease (48%) than for peptic ulcer disease prevention (5%).
Conclusions:
- Proton pump inhibitor prescribing in hospitalized children frequently deviates from established guidelines.
- Enhanced education on PPI recommendations for pediatricians is crucial to improve prescribing practices.
Objective:
The use of proton pump inhibitors has increased exponentially over the past 20 years. Several side effects have been reported and concerns exist about the consequences of long-term proton pump inhibitors on health, leading to limitation of their use. The present study analyzed prescriptions of proton pump inhibitors at inpatient units and assessed their compliance with current recommendations.
Methods:
This single-center, observational, retrospective study reviewed medical file of patients hospitalized at the pediatric medical departments of the Bordeaux University Hospital between April 1 and September 30, 2019. Patients younger than 18 years, hospitalized in the pediatric hospital units and treated with proton pump inhibitors were included. Prescriptions of proton pump inhibitors were compared with French and international guidelines.
Results:
Proton pump inhibitors were prescribed for 251 of 2237 children (11%), mainly for gastroesophageal reflux disease (47%) and prevention of peptic ulcer disease (32.7%). Proton pump inhibitor prescription complied to recommendations in 34.5% of cases, less often in children aged younger than 1 year (13.5%) than in older children. Compliance to recommendations was lower when proton pump inhibitors were indicated for the prevention of peptic disease (5%) than for gastroesophageal reflux disease (48%).
Conclusions:
Proton pump inhibitors are frequently prescribed for hospitalized children, and indications comply with recommendations in only 35% of the cases. Efforts in spreading awareness of the recommendations on the use of proton pump inhibitors in children are mandatory among hospital pediatricians.
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