The findings of a new study are raising concerns about the frequent use of heartburn medications, including proton pump inhibitors, in infants. The authors of the paper, which appeared last month in The Journal of Pediatrics, have called for additional research into the effects of these drugs on this patient population.
The study consisted of a retrospective analysis of about 122,000 infants admitted to children’s hospitals within the Pediatric Health Information System database between January 2006 and March 2013. The research team analyzed the data to determine frequency of treatment with either a proton pump inhibitor or an H-2 blocker, as well as timing/duration of treatment, factors associated with use, and percent of infants remaining on treatment at discharge.
The analysis revealed that nearly 24% of the infants had been treated with either class of heartburn medications, with 19% having received an H-2 blocker and 10.5% receiving a proton pump inhibitor. Those most likely to be prescribed the drugs included extremely preterm infants and term infant. Additionally, babies with gastroesophageal reflux disease and congenital heart disease had the highest treatment probabilities, followed by babies with an ear, nose, and throat diagnosis. Most treated infants were still receiving the drugs at discharge.
“Despite limited evidence and increasing safety concerns, H2RAs/PPIs are frequently prescribed to extremely preterm neonates and those with congenital anomalies and continued through discharge,” the authors report. “Our findings support the need for innovative studies to examine the comparative effectiveness and safety of H2RA/PPIs vs. no treatment in these high-risk neonatal populations.”
Proton pump inhibitors include prescription medications sold under the brand names Nexium, Prilosec, Prevacid, and others. A number of over-the-counter brands are also available. Data indicates that more than 15 million people were prescribed one of these drugs in 2013, while millions more used Nexium24Hr or another OTC brand. But a study published earlier this year in JAMA Internal Medicine found that as many as 70% of proton pump inhibitor prescriptions are inappropriate, and that a quarter of all users could stop taking the medications without an increase or recurrence of their heartburn symptoms.
Recent studies have also suggested that long-term use of proton pump inhibitors may increase a patient’s risk for kidney failure and chronic kidney disease, as well as dementia and heart attacks. Other side effects potentially associated with their extended use include certain bone fractures, C. diff infections, low magnesium levels and B12 deficiency.