- Duncan DR, et al. JAMA Otolaryngol Head Neck Surg. Oct. 11, 2018, http://bit.ly/2PsPKCa.
Children with trouble swallowing had twice the risk of hospitalization if they were treated with proton pump inhibitors (PPIs).
The acid suppressing medications have been linked to pulmonary and gastrointestinal infections but still are commonly used for oropharyngeal dysphagia, perhaps due to similarities with reflux, authors wrote.
To determine if PPIs were linked to increased hospitalization, they reviewed the charts of 293 children age 2 years and younger with abnormal results on videofluoroscopic swallow studies at Boston Children’s Hospital in 2015 with follow-up through 2016.
About 53% of the patients had aspiration and 47% had isolated laryngeal penetration. Nearly half of the children were hospitalized. The mean was one admission and four nights in the hospital.
Roughly 51% of all children with swallowing difficulties were treated with PPI, primarily omeprazole. Others received lansoprazole or pantoprazole. The children receiving a PPI had twice the risk of hospitalization and two to three times the risk of spending the night in the hospital compared to those not treated with a PPI. The results held up after adjusting for comorbidities.
Those at highest risk of hospital admission were children with both enteral tubes and PPIs.
Children were hospitalized for pulmonary issues like tachypnea, wheezing, respiratory distress and pneumonia and gastrointestinal issues like feeding, vomiting and diarrhea.
“These results support growing concerns about potential risks of PPIs and suggest the need to reevaluate the use of pharmacologic acid suppression in children with aspiration,” authors wrote.