Side Effects and Complications of Proton Pump Inhibitors: A Pediatric Perspective

Stark, Christopher M.; Nylund, Cade M.

doi:10.1016/j.jpeds.2015.08.064

Cited by 34 publications

(30 citation statements)

References 81 publications

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“…There is mounting evidence that maintenance of a physiologic gastric acid barrier may be important in preventing CDI, although acid-suppression medications may increase the risk of infections through other mechanisms. 19 Several studies of CDI in children support our findings that recent exposure to gastric acid-suppression medications is associated with CA-CDI. 7,20,21 We found that the odds of CA-CDI development following proton pump inhibitor and H2 receptor antagonist exposure were similar to that seen with antibiotic exposures.…”

Section: Discussionsupporting

confidence: 82%

Risk Factors for Community-Associated Clostridium difficile Infection in Children

Adams

Eberly

Rajnik

et al. 2017

The Journal of Pediatrics

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Section: Discussionsupporting

confidence: 82%

Risk Factors for Community-Associated Clostridium difficile Infection in Children

Adams

Eberly

Rajnik

et al. 2017

The Journal of Pediatrics

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“…The acidification of the bee gut lumen by symbionts could explain how a strong core microbiota resists invasion by pathogens. This hypothesis is consistent with the dominant role of pH in determination of bacterial communities in soil (58, 59), and correlations between low gastric acidity and opportunistic infection in human subjects (76). However, other explanations for the effects of core gut microbiota on parasites—such as physical competition for space and resources, enhancement of the immune response, and improvement of host nutritional status (6)—also deserve consideration.…”

Section: Discussionsupporting

confidence: 85%

pH-mediated inhibition of a bumble bee parasite by an intestinal symbiont

Palmer‐Young

Raffel

McFrederick

2018

Preprint

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Palmer-Young et al. pH mediates inhibition of a bee parasite by symbionts 1 pH-mediated inhibition of a bumble 1 bee parasite by an intestinal symbiont 2 3 Running title: pH mediates inhibition of a bee parasite by symbionts 4 5 ABSTRACT 13Non-pathogenic microbes can provide multiple benefits to their hosts, including pathogen 14 inhibition. Gut symbionts can augment resistance to pathogens by stimulating host immune responses, 15 competing for space and nutrients, or producing antimicrobial metabolites. The gut microbiota of social 16 bees, which pollinate many crops and wildflowers, has demonstrated benefits against diverse infections 17 and might help protect against pathogen-related declines. The bumble bee gut microbiota, consisting 18 chiefly of five taxa common to corbiculate bees, has been shown to enhance resistance to the 19 trypanosomatid parasite Crithidia bombi. Specifically, infection intensity was negatively correlated with 20 abundance of Lactobacillus "Firm-5" bacteria. However, the mechanism underlying this relationship 21 remains unknown. We tested the hypothesis that the Firm-5 bacterium Lactobacillus bombicola, which 22Acidification Experiment: pH-dependent inhibition of C. bombi with different sources of 132 acidity. Having established pH-dependent growth inhibition, we conducted a follow-up experiment to 133 quantify C. bombi growth rates across a range of pH values, and to compare the relative inhibitory 134 effects of L. bombicola spent medium with that of three other sources of acidity: HCl, L-lactic acid (the 135 form produced by animal cells (53)), and D-lactic acid (the form produced by L. bombicola (41)). We used 136

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“…The potential role of antiacid secretion medications and obesity may be confounded by the presence of underlying disease that could negatively impact growth. Additionally, established negative side effects of PPIs, including increased risk of respiratory and GI infections, may also lead to subsequent weight loss in paediatric patients prescribed PPIs 45. Susceptibility to infection may be a possible uncontrolled confounder in our study.…”

Section: Discussionmentioning

confidence: 93%

Antibiotic and acid-suppression medications during early childhood are associated with obesity

Stark

Susi

Emerick

et al. 2018

Gut

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ObjectiveGut microbiota alterations are associated with obesity. Early exposure to medications, including acid suppressants and antibiotics, can alter gut biota and may increase the likelihood of developing obesity. We investigated the association of antibiotic, histamine-2 receptor antagonist (H2RA) and proton pump inhibitor (PPI) prescriptions during early childhood with a diagnosis of obesity.DesignWe performed a cohort study of US Department of Defense TRICARE beneficiaries born from October 2006 to September 2013. Exposures were defined as having any dispensed prescription for antibiotic, H2RA or PPI medications in the first 2 years of life. A single event analysis of obesity was performed using Cox proportional hazards regression.Results333 353 children met inclusion criteria, with 241 502 (72.4%) children prescribed an antibiotic, 39 488 (11.8%) an H2RA and 11 089 (3.3%) a PPI. Antibiotic prescriptions were associated with obesity (HR 1.26; 95% CI 1.23 to 1.28). This association persisted regardless of antibiotic class and strengthened with each additional class of antibiotic prescribed. H2RA and PPI prescriptions were also associated with obesity, with a stronger association for each 30-day supply prescribed. The HR increased commensurately with exposure to each additional medication group prescribed.ConclusionsAntibiotics, acid suppressants and the combination of multiple medications in the first 2 years of life are associated with a diagnosis of childhood obesity. Microbiota-altering medications administered in early childhood may influence weight gain.

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Side Effects and Complications of Proton Pump Inhibitors: A Pediatric Perspective

Cited by 34 publications

References 81 publications

Risk Factors for Community-Associated Clostridium difficile Infection in Children

Risk Factors for Community-Associated Clostridium difficile Infection in Children

pH-mediated inhibition of a bumble bee parasite by an intestinal symbiont

Antibiotic and acid-suppression medications during early childhood are associated with obesity

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