Proton Pump Inhibitor Use in Infants and Children

A Review of the Recent Literature

Marcia L. Buck, PharmD, FCCP, FPPAG, BCPPS


Pediatr Pharm. 2019;25(7) 

In This Article

Allergic Disease

In spite of earlier studies attempting to address the issue, there are still questions about the relationship between early exposure to gastric acid suppression and the development of allergies in young children. In the June 2018 issue of JAMA Pediatrics, Mitre and colleagues explored this relationship as part of study also evaluating antibiotic exposure.[12] The authors used data from 792,130 children included in the United States Department of Defense (US DoD) TRICARE database between 2001 and 2013. All patients had been enrolled within 35 days of birth and were followed for a mean of 4.6 years. A total of 60, 209 (7.6%) of the patients received an H2RA, while 13,687 (1.7%) were treated with a PPI during the first 6 months of life. Adjusted hazard ratios for H2RA and PPIs for food allergy were 2.18 (95% CI 2.02–2.33) and 2.59 (95% CI 2.25–3.00), respectively, for medication allergy 1.70 (95% CI 1.60–1.80) and 1.84 (95% CI 1.56–2.17), for anaphylaxis 1.51 (95% CI 1.38–1.66) and 1.45 (95% CI 1.22–1.73), for allergic rhinitis 1.50 (95% CI 1.46–1.54) and 1.44 (95% CI 1.36–1.52), and for asthma 1.25 (95% CI, 1.21–1.29) and 1.41 (95% CI, 1.31–152). The results from this analysis suggest associations between both H2RA and PPIs and the development of allergic disease.