Infant PPI Use and Lung Infection Risk: Is There a Link?

The use of PPIs in otherwise healthy infants has been debated, as some studies have failed to show symptomatic relief.
The use of PPIs in otherwise healthy infants has been debated, as some studies have failed to show symptomatic relief.

Infants using common anti-reflux medications do not appear to be at increased risk for community-acquired pneumonia or other lower respiratory tract infections, according to findings from University of Otago study published in the Journal of Pediatric Gastroenterology and Nutrition.

The use of proton pump inhibitors (PPIs) in otherwise healthy infants has been debated as previous studies have failed to demonstrate symptomatic relief in those with presumed acid reflux. Further, international studies have shown an association with PPI use and pneumonia in adults; 2 other studies have suggested a risk of lung infections in infants who use PPIs. 

Study authors analyzed health records of 21,991 infants in New Zealand (born between January 2005 and December 2012), as the country was found to have high rates of PPI use from a previous study. They evaluated infants prescribed omeprazole, lansoprazole or pantoprazole at least once before their first birthday for incidence of community-acquired pneumonia or other lower respiratory tract infection. Up to 10 controls were matched for each case, defined as a patient with a first diagnosis after PPI dispensing.

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The data showed matched odds ratio for current vs past use of PPIs to be 0.88 (95% CI, 0.36 to 2.16) when comparing cases and their controls for community-acquired pneumonia. With regard to lower respiratory tract infections, the matched odds ratio between cases and their controls was 1.13 (95% CI, 0.87 to 1.48). 

"Not only did we find a relatively low number of serious lung infections among the children in the cohort, but healthy infants who were currently using PPIs were at no greater risk of a lung infection than healthy infants who had stopped taking PPIs," Dr Lianne Parkin stated, co-author of the study and senior lecturer in epidemiology in the Department of Preventive and Social Medicine.

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