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
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.