Despite reported risks, nearly one in four infants in neonatal intensive care units (NICUs) are given stomach acid-suppressing drugs, researchers report.
However, they noted that the use of these medications has started to decline some in recent years.
A number of studies have linked the use of stomach acid-suppressing drugs in hospitalized high-risk infants with infections, necrotizing enterocolitis (a serious disease where intestinal tissue begins to die off) and increased risk of death, the researchers said.
These drugs include histamine-2 receptor antagonists such as ranitidine (Zantac), and proton pump inhibitors such as esomeprazole (Nexium).
Researchers at Nationwide Children’s Hospital in Columbus, Ohio, analyzed data from 43 children’s hospitals across the United States from 2006 to 2013. They found that nearly 24 percent of roughly 122,000 newborns received either a histamine-2 receptor antagonist or proton pump inhibitor.
“The number is surprising, because there are now multiple studies that say these drugs are associated with harmful effects,” said study author Dr. Jonathan Slaughter, a neonatologist at Nationwide Children’s.
Babies most likely to be given the drugs were those diagnosed with gastroesophageal reflux disease (GERD); congenital heart disease; and ear, nose and throat conditions, according to the study published April 27 in The Journal of Pediatrics.
But, “there’s actually little evidence that acid suppression helps in the NICU at all,” Slaughter said in a hospital news release.
The researchers did find that the percentage of babies treated with histamine-2 receptor antagonists declined some during the study period. While the percentage of babies treated with proton pump inhibitors rose until 2010, it declined afterward.
“It’s encouraging that doctors are starting to pay attention to the warnings and decrease usage,” Slaughter said.
“In the small premature babies who are prescribed acid-suppressive medications, doctors are waiting longer, until they are a little older. That’s promising,” Slaughter said.
“But I think the numbers should be declining faster, and the research community should continue to devote resources to study the drugs’ effectiveness and safety,” he added.
The Mayo Clinic has more about reflux in infants.
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