Gastric acidity inhibitors and the risk of intestinal infections.
OBJECTIVE
We reviewed recent clinical studies performed in adults, children, and neonates exploring the possible association of gastric acidity inhibitors use with intestinal infections. Possible mechanisms have also been reported.


RESULTS
Many studies and systematic reviews demonstrate an increased risk of bacterial infection in adults taking acid suppressors. Little evidence is derived from the pediatric population. The use of gastric acidity inhibitors has been associated with systemic infections and necrotizing enterocolitis in preterm infants. Reduced gastric acidity, delayed gastric emptying, increased gastric mucus viscosity, modification in microbiota, and impairment of neutrophils functions, are all conditions determined by gastric acidity blockers that potentially lead to an increased risk of gastrointestinal infections.


CONCLUSIONS
A proper utilization of these drugs, particularly for patients at high risk, is imperative in order to reduce deleterious effects on infection risk and to optimize cost-effectiveness ratio.
Canani
Roberto Berni
RB
Department of Pediatrics, University of Naples, Naples, Italy. berni@unina.it
Terrin
Gianluca
G
D000328:Adult; D000367:Age Factors; D000897:Anti-Ulcer Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016022:Case-Control Studies; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005744:Gastric Acid / Q000378:metabolism*; D005745:Gastric Acidity Determination; D005759:Gastroenteritis / Q000139:chemically induced* / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D054328:Proton Pump Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment
D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors