Early Use of Proton Pump Inhibitors Increases Risk of Upper Respiratory Tract Infections in Children: A Birth Cohort Study.
Early proton pump inhibitor use in infancy linked to higher odds of otitis media
Early Use of Proton Pump Inhibitors Increases Risk of Upper Respiratory Tract Infections in Children: A Birth Cohort Study.
Proton pump inhibitors (pump inhibitors) are frequently prescribed in infancy for functional gastrointestinal disorders such as colic and gastroesophageal reflux, despite limited evidence of benefit and potential risk.
We aimed to examine the association between early pump inhibitors exposure and respiratory tract infections (respiratory tract infections) in a birth cohort.
In the ARIES cohort (Santiago, Chile), 200 of 265 children with complete data were followed from birth to 24 months.
early pump inhibitors exposure sharply raised the odds of otitis media
Sixteen infants (8%) received PPIs during the first 6 months and 22 (11%) during the first 2 years.
By age two, otitis media occurred in 12%, viral croup in 18%, bronchiolitis in 36%, pneumonia in 2.5%, respiratory tract infections-related hospitalization in 3%, and respiratory tract infections-related antibiotic use in 38%.
Any pump inhibitors exposure also increased odds of otitis media (aOR 5.4, 95% CI 1.4-21.0), viral croup (aOR 3.0, 95% CI 1.1-8.1), respiratory tract infections-related hospitalization (aOR 17.5, 95% CI 1.5-205.0), and antibiotic use (aOR 8.9, 95% CI 2.9-27.1).
No significant associations were observed with lower respiratory tract infections.
Early pump inhibitors exposure in infancy is associated with higher risk of upper respiratory tract infections, respiratory tract infections-related hospitalization and antibiotic prescriptions.
These findings underscore the importance of cautious pump inhibitors prescribing in early life, a critical period for immune and microbiota development.