Choosing Wisely:

Don’t treat gastroesophageal reflux in infants routinely with acid suppression therapy.

Rationale and Comments: Antireflux therapy has been demonstrated to have no effect in reducing the symptoms of gastroesophageal reflux disease (GERD) in children. Concerns regarding the use of proton pump inhibitor therapy in infants include an inability to definitively diagnose pediatric patients according to the established criteria of GERD, lack of documented efficacy of acid suppression therapy in infants, and the potential adverse effects associated with acid suppression therapy.
Sponsoring Organizations:
  • Society of Hospital Medicine (Pediatric)
  • Sources:
  • Systematic review of RCTs
  • Disciplines:
  • Pediatric
  • Gastroenterologic
  • References: • Vandenplas Y. Pediatric gastroesophageal reflux clinical practice guidelines. J Pediatr Gastroenterol Nutr. 2009;49: 498-547.
    • Van der Pol RJ, et al. Efficacy of proton-pump inhibitors in children with gastroesophageal reflux: a systematic review. Pediatrics. 2011;127(5):925-35.
    • Gibbons TE, et al. The use of proton pump inhibitors in children: a comprehensive review. Paediatr Drugs. 2003;5(1): 25-40.
    • Orenstein SR, et al. Infants and proton pump inhibitors: tribulations, no trials. J Pediatr Gastroenterol Nutr. 2007;45:395-8.
    • Khoshoo V, et al. Are we overprescribing antireflux medications for infants with regurgitation? Pediatrics. 2007;120:946-9.

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