title: Inhibitors of gastric acid secretion drugs increase neonatal morbidity and mortality.
abstract: OBJECTIVE
  To analyze all evidence on the possible increase in morbidity and mortality determined by the use of inhibitors of gastric acid secretion (IGAS) drugs.
  
  
  METHODS
  We review all evidence exploring the adverse events associated with IGAS use in neonates.
  
  
  RESULTS
  Despite being prescribed in an off-label manner because of the perceived safety and potential benefit demonstrated for older populations, IGAS are being increasingly used in the neonatal period with much evidence derived from adults and children. Few data are available for neonates and indicate an association between IGAS use with infections and necrotizing enterocolitis (NEC), and with an increased mortality. Delayed gastric emptying, increased gastric mucus viscosity, modification in microbiota, and impairment of neutrophils functions are possible mechanisms of adverse events associated with IGAS use.
  
  
  CONCLUSIONS
  A careful prescription of IGAS is crucial in order to reduce iatrogenic damage in neonates.
authors.affiliation: Department of Gynecology-Obstetrics and Perinatal Medicine, University La Sapienza, Rome, Italy. gianluca.terrin@uniroma1.it
authors.forename: Gianluca
authors.initials: G
authors.lastname: Terrin
authors.forename: Roberto Berni
authors.initials: RB
authors.lastname: Canani
authors.forename: Annalisa
authors.initials: A
authors.lastname: Passariello
authors.forename: Stefano
authors.initials: S
authors.lastname: Caoci
authors.forename: Mario
authors.initials: M
authors.lastname: De Curtis
mesh_terms: D000328:Adult; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000401:mortality; D020345:Enterocolitis, Necrotizing / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D005744:Gastric Acid / Q000378:metabolism; D005765:Gastrointestinal Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality*; D007239:Infections / Q000151:congenital / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D009017:Morbidity
chemical_list: D005765:Gastrointestinal Agents