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Systematic review: proton pump inhibitors for the treatment of gastroesophageal reflux in infants

Author(s): Dorota Gieruszczak-Białek | Agata Skórka | Hanna Szajewska

Journal: Pediatria Współczesna
ISSN 1507-5532

Volume: 10;
Issue: 3;
Start page: 150;
Date: 2008;
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Keywords: gastric acid inhibitors | GERD | children

Introduction: Currently, proton pump inhibitors (PPI) are increasingly being used to treat infants with gastroesophageal reflux disease (GERD). However, evidence of the role of PPI as a primary treatment for GERD remains unclear. Aim of study: We aimed to systematically evaluate the published randomized controlled trials (RCTs) evaluating the efficacy and safety of PPI for the treatment of GERD in infants. Material and methods: Using medical subject headings and free-language terms, we searched the Cochrane Central Register of Control­led Trials (CENTRAL), MEDLINE, EMBASE, CINAHL databases, and proceedings of the European and North American pediatric gastro-enterology conferences (from 2000) in October 2007; additional references were obtained from reviewed articles. Results: 2 studies were eligible for inclusion. Study quality was reasonable. Moore 2003 enrolled 30 irritable infants with GER diagnosis thatwas basedon esophageal biopsy and pH criteria. Omari 2007 enrolled 10 premature infants with reflux symptoms and pathological acid reflux on 24-h pH probe. Meta-analysis of 2 RCTs found significant difference in reflux index (weighted mean difference -4.8%, 95% CI -7 to -2) in infants treated with omeprazole. 1 RCT reported a significant reduction in number of acid GER episodes (mean dif­ference, MD -60, 95% CI -127 to -7), number of reflux episodes of pH5 minutes, and duration of longest episode of pH

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