PPIs can Heighten the Risk of Serious Infections in Children

A new study aimed to investigate the connection between proton pump inhibitor (PPI) use and severe infections in children – considering the potential impact on microbiota and the immune system. 

This was a nationwide cohort study that utilized the French Health Data System. Here, the researchers analyzed data from 1,262,424 children born between 2010-2018 who were treated for gastroesophageal reflux or related disorders with medications such as – PPIs, histamine 2 receptor antagonists, or antacids/alginate. 

The results revealed that PPI exposure was linked to an increased risk of serious infections overall, with adjusted hazard ratios (aHRs) – indicating a 34% higher risk. The association persisted across various infection sites, including the digestive tract, ear, nose, and throat sphere, lower respiratory tract, kidneys or urinary tract, and nervous system. Further, both bacterial and viral infections showed elevated risks in children exposed to PPIs. The population was followed for a median of 3.8 years and comprised – 606,645 children who received PPIs and 655,779 who did not. 

The findings underscored the importance of avoiding PPI use in young children without a clear medical indication. The study recommended cautious consideration of the risks associated with PPIs in this population, emphasizing the need for a judicious approach to their prescription.

Source: Lassalle M, Zureik M, Dray-Spira R. JAMA pediatrics. 2023 Oct 1;177(10):1028-38.