Abstract
Clinical guidelines emphasized that physicians should be cautious when prescribing acid suppressions to infants. Histamine-2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) are not approved for use in infants aged below 2 years in China. We investigated H2RA/PPI use in infants aged below 2 years hospitalized between 1st January 2015 and 31st December 2018 in a Chinese tertiary children's hospital. Our study observed that H2RAs/PPIs were frequently prescribed with a prevalence of 4.4% (7,158/162,192). The frequency of PPI use was over two-fold than that of H2RA use (71.9%, 5,148/7,158; 28.1%, 2,011/7,158). H2RAs/PPIs were commonly used to treat infants without digestive system diseases (57.5%, 4,118/7,158). Further studies are urgently needed to evaluate the effectiveness and safety of H2RAs/PPIs in infants.
Highlights
Histamine-2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) are acid suppressions for gastric acid-related disorders
Infants covered by the New Rural Cooperative Medical Insurance (NRCMS) or without medical insurance were more likely to use H2RAs than PPIs (OR = 0.7, 95% confidence intervals (CIs) 0.6–0.9, P < 0.001; odds ratios (ORs) = 0.8, 95% CI 0.7–0.9, P = 0.001)
We observed that H2RAs/PPIs were not approved in China for infants, they were frequently prescribed for the population, commonly being used to treat the infants without digestive system diseases
Summary
Histamine-2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) are acid suppressions for gastric acid-related disorders. Of 162,192 admissions of patients aged below 2 years in the databases during the study period, 7,158 (4.4%) admissions of the infants treated with H2RAs/PPIs were included. During the 4-year study period, the prevalence of total H2RA/PPI use was 4.3%, 4.4%, 4.6%, and 4.4%, respectively. The factors associated with H2RA/PPI selection included characteristics and diagnoses of the patients. The regression demonstrated infants aged above 28 days were more likely to be prescribed PPIs than H2RAs (OR = 21.6, 95% CI 17.9–26.1, P < 0.001; OR = 7.6, 95% CI 6.3–9.2, P < 0.001). Compared with H2RAs, there was a positive correlation between diagnoses including digestive system diseases and PPI use (OR = 2.0, 95% CI 1.8–2.3, P < 0.001) (Table 1)
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