title: Are there risks associated with empiric acid suppression treatment of infants and children suspected of having gastroesophageal reflux disease?
abstract: BACKGROUND
  It has become common practice to empirically treat infants and children who have suspected gastroesophageal reflux disease by using acid-suppressive medications. However, evidence to support the effectiveness of these medications in the pediatric population is limited. With multiple studies in adult patients indicating increased risk of infection, we reviewed the literature to determine the association between acid-suppressive medications and serious adverse effects in infants and children.
  
  
  METHODS
  We conducted a PubMed search on the adverse effects of H2 antagonists and proton pump inhibitors in pediatric patients. The studies selected were original research and systematic reviews with control groups and study objectives evaluating the relationship between acid-suppressive medications and serious adverse effects (namely, infections).
  
  
  RESULTS
  Fourteen studies met our inclusion criteria. The majority of studies found a significant association between acid-suppressive medications and the risk of necrotizing enterocolitis, sepsis/bacteremia, pneumonia, and gastrointestinal infections in infants and children.
  
  
  CONCLUSIONS
  Given the questionable efficacy of H2 antagonists and proton pump inhibitors and the growing evidence of increased risk of serious infections, acid-suppressive medications should be used cautiously in infants and children suspected of having gastroesophageal reflux disease.
authors: The Warren Alpert Medical School of Brown University, Rhode Island Hospital/Hasbro Children's Hospital, Providence, Rhode Island, USA. echung@lifespan.org
authors: Erica Y
authors: EY
authors: Chung
authors: Jeremy
authors: J
authors: Yardley
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D020345:Enterocolitis, Necrotizing / Q000209:etiology*; D019317:Evidence-Based Medicine; D005759:Gastroenteritis / Q000209:etiology; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D006635:Histamine H2 Antagonists / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011014:Pneumonia / Q000209:etiology*; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D018805:Sepsis / Q000209:etiology*; D016896:Treatment Outcome
chemical_list: D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors