PPI exposure can make children susceptible to serious infections

The use of proton pump inhibitors (PPIs) appears to pose heightened risks of serious infections in young children, according to a study.

For the study, researchers used data from the Mother-Child EPI-MERES Register built from the French Health Data System. A total of 1,262,424 children who received a treatment for gastroesophageal reflux disease or other gastric acid–related disorders (ie, PPIs, histamine 2 receptor antagonists [H2RAs], or antacids/alginate) were included. The index date was defined as the first date the medication was dispensed. The median follow-up duration was 3.8 years.

Of the children included in the study, 606,645 received PPI (median age at index date 88 days, 53.4 percent boys) and 655,779 did not receive PPI (median age at index date 82 days, 52.2 percent boys).

Multivariate Cox regression models showed that PPI exposure was associated with a 34-percent increase in the risk of serious infections overall compared with nonexposure (adjusted hazard ratio [aHR], 1.34, 95 percent confidence interval [CI], 1.32–1.36).

Specifically, a risk increase was seen for infections in the digestive tract (aHR, 1.52, 95 percent CI, 1.48–1.55); in the ear, nose, and throat sphere (aHR, 1.47, 95 percent CI, 1.41–1.52); lower respiratory tract (aHR, 1.22, 95 percent CI, 1.19–1.25); kidneys or urinary tract (aHR, 1.20, 95 percent CI, 1.15–1.25); and nervous system (aHR, 1.31, 95 percent CI, 1.11–1.54).

The increased risk of infections associated with PPI exposure was true for both bacterial (aHR, 1.56, 95 percent CI, 1.50–1.63) and viral infections (aHR, 1.30, 95 percent CI, 1.28–1.33).

In light of the findings, the researchers recommended that PPI not be used without a clear indication in young children.