Adverse effects reported in the use of gastroesophageal reflux disease treatments in children: a 10 years literature review.
Gastroesophageal reflux (GER) is commonly observed in children, particularly during the first year of life. Pharmacological therapy is mostly reserved for symptomatic infants diagnosed with GER disease (GERD), usually as defined in a recent consensus statement. The purpose of the present article was to review the reported adverse effects of pharmacological agents used in the treatment of paediatric GERD. We conducted this review using the electronic journal database Pubmed and Cochrane database systematic reviews using the latest 10-year period (1 January 2003 to 31 December 2012). Our search strategy included the following keywords: omeprazole, esomeprazole, lansoprazole, pantoprazole, rabeprazole, rantidine, cimetidine, famotidine, nizatidine, domperidone, metoclopramide, betanechol, erythromycin, baclofen, alginate. We used Pubmed's own filter of: 'child: birth-18 years'. All full articles were reviewed and we only included randomized controlled trials retrieved from our search. We addressed a summary of our search on a drug-by-drug basis with regard to its mechanism of action and clinical applications, and reviewed all of the adverse effects reported and the safety profile of each drug. Adverse effects have been reported in at least 23% of patients treated with histamine H2 receptor antagonists (H2 RAs) and 34% of those treated with proton pump inhibitors (PPIs), and mostly include headaches, diarrhoea, nausea (H2 RAs and PPIs) and constipation (PPIs). Acid suppression may place immune-deficient infants and children, or those with indwelling catheters, at risk for the development of lower respiratory tract infections and nosocomial sepsis. Prokinetic agents have many adverse effects, without major benefits to support their routine use.
The Pediatric Gastroenterology unit.|Department of Pediatrics, 'Dana-Dwek' Children's Hospital, Tel Aviv Medical Center and, the.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel and.
Shlomi
S
Cohen
The Pediatric Gastroenterology unit.|Department of Pediatrics, 'Dana-Dwek' Children's Hospital, Tel Aviv Medical Center and, the.
Mirjam
M
Bueno de Mesquita
Department of Pediatrics, 'Dana-Dwek' Children's Hospital, Tel Aviv Medical Center and, the.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel and.|Division of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel.
Francis B
FB
Mimouni
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000209:etiology*; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D006635:Histamine H2 Antagonists / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use
D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors
antacids; children; gastroesophageal reflux disease; histamine H2 receptor antagonists; metoclopramide; prokinetics; proton pump inhibitors