Proton pump inhibitors (PPIs) are commonly used medications to reduce stomach acid production and treat conditions like gastro-oesophageal reflux disease (GERD/GORD). However, recent research has uncovered associations between PPI use and serious infections in young children.

Published in JAMA Pediatrics, the French study’s findings indicate that using PPIs in young children might be linked to an elevated risk of serious infections. This heightened risk wasn’t limited to a specific infection type, extending to various parts of the body and different pathogens.

For instance, children exposed to PPIs faced increased risks of infections in areas such as the digestive tract, ear, nose and throat, lower respiratory tract, kidneys or urinary tract, and nervous system. Both bacterial and viral infections were found to have an increased risk among children who had been exposed to PPIs.

The study draws its strength from comprehensive data derived from the French Health Data System, offering insights into the entire population. Specifically, the researchers examined data from the EPI-MERES Register in France, a nationwide cohort study that included over 1.2 million children born between 2010 and 2018.

Additionally, sensitivity analyses were employed to address biases. However, the study does have limitations, such as the absence of data on specific treatment indications and other influencing factors.

Study highlights concerns

While PPIs are effective for managing GERD symptoms in adults, this study highlights potential concerns when used in young children. The potential association with an increased risk of serious infections underscores the importance of careful consideration.

In recent years, the use of acid reducers has been on the rise among young children in high-income countries. For instance, in France, the percentage of children under two years old using these medications increased from 3.6 per cent in 2010 to 6.1 per cent in 2019.

Similarly, New Zealand saw an increase in prevalence from 2.4 per cent to 5.2 per cent between 2005 and 2012 during a child’s first year of life. In Sweden, Norway, and Denmark, prescription rates have climbed to 1.9 per cent, 2.3 per cent, and 4.6 per cent respectively in 2020, marking a substantial three to five-fold increase since 2000.

Previous studies have hinted at associations between PPI usage and various health concerns in children, including bone fractures, acute kidney injury, allergies, asthma, and inflammatory bowel diseases.

Moreover, concerns have arisen about the potential for PPIs to contribute to infections through changes in pH levels or direct effects on the immune system. Despite the heightened vulnerability of young children to infections, limited real-life data exists to fully comprehend this risk.

Researchers of this new study say parents, caregivers, and healthcare professionals should weigh the potential benefits and risks of using PPIs in children, making informed decisions with guidance from medical experts.

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