University of Otago research has found that the use of popular anti-reflux medicines like omeprazole before a child’s first birthday did not put them at increased risk of pneumonia or other lower respiratory tract infections, contrary to findings from other international studies.

Lead researcher Mei-Ling Blank from the Department of Preventive and Social Medicine says use of the drugs – proton pump inhibitors (PPIs) – by otherwise healthy infants is controversial as studies have repeatedly failed to demonstrate that the drugs relieve the symptoms of presumed acid reflux in infants.

Other studies indicate that the dispensing of PPIs for parents concerned by the infant’s excessive crying or irritability – also referred to as infantile colic – has increased in recent years, raising concerns over whether they are safe.

“Several large overseas studies have observed an association between the use of PPIs and pneumonia in adults, while two small studies conducted overseas suggested that infants using PPIs may also be at risk of lung infections,” said Blank.

PPIs are commonly prescribed to infants for symptoms attributed to acid reflux or heartburn, with an earlier study by the Otago researchers finding New Zealand has among the highest rates of PPI use by infants internationally.

“Given the high rates of PPI use that one of our earlier studies found, it was important to investigate if infants in New Zealand who were using PPIs were at increased risk of serious lung infections,” said Blank.

Co-author of the study, Senior Lecturer in Epidemiology in the Department of Preventive and Social Medicine Dr Lianne Parkin says the Otago study was the largest of its kind internationally and was able to address some of the methodological limitations of previous studies.

“We found that not only were there a relatively low number of serious lung infections among the children in the cohort, but also that healthy infants who were currently using PPIs were at no greater risk of lung infections than healthy infants who had stopped taking PPIs,” Dr Parkin says.

The study examined the health records of more than 21,000 New Zealand infants born between January 2005 and December 2012 who were presecribed omeprazole, lansoprazole or pantoprazole at least once before their first birthday. The study was published today in the international Journal of Paediatric Gastroenterology and Nutrition.

Other researchers involved in the Otago study are Dr Jiaxu Zeng and Dave Barson from the Department of Preventive and Social Medicine. Funding for the study came from the New Zealand Pharmacovigilance Centre, Medsafe and a Strategic Research Grant from the Department of Preventive and Social Medicine.

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