Affiliation:
1. Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital AMC, Amsterdam, Netherlands;
2. Center for Pediatric and Adolescent Gastroenterology, Women's and Children's Hospital, Children, Youth and Women's Health Service, North Adelaide, Australia; and
3. School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia
Abstract
INTRODUCTION:
Use of proton-pump inhibitors (PPIs) for the treatment of gastroesophageal reflux disease (GERD) in children has increased enormously. However, effectiveness and safety of PPIs for pediatric GERD are under debate.
OBJECTIVES:
We performed a systematic review to determine effectiveness and safety of PPIs in children with GERD.
METHODS:
We searched PubMed, Embase, and the Cochrane Database of Systematic Reviews for randomized controlled trials and crossover studies investigating efficacy and safety of PPIs in children aged 0 to 18 years with GERD for reduction in GERD symptoms, gastric pH, histologic aberrations, and reported adverse events.
RESULTS:
Twelve studies were included with data from children aged 0–17 years. For infants, PPIs were more effective in 1 study (compared with hydrolyzed formula), not effective in 2 studies, and equally effective in 2 studies (compared with placebo) for the reduction of GERD symptoms. For children and adolescents, PPIs were equally effective (compared with alginates, ranitidine, or a different PPI dosage). For gastric acidity, in infants and children PPIs were more effective (compared with placebo, alginates, or ranitidine) in 4 studies. For reducing histologic aberrations, PPIs showed no difference (compared with ranitidine or alginates) in 3 studies. Six studies reported no differences in treatment-related adverse events (compared with placebo or a different PPI dosage).
CONCLUSIONS:
PPIs are not effective in reducing GERD symptoms in infants. Placebo-controlled trials in older children are lacking. Although PPIs seem to be well tolerated during short-term use, evidence supporting the safety of PPIs is lacking.
Publisher
American Academy of Pediatrics (AAP)
Subject
Pediatrics, Perinatology, and Child Health
Cited by
201 articles.
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