Abstract
Acid-related disorders are frequently encountered in pediatric practice. In addition to lifestyle modifications, effective management by suppression of gastric acid production is the most important management strategy for gastroesophageal reflux disease (GERD). Proton-pump inhibitors are the drugs of choice for the treatment of GERD. Esomeprazole is the latest proton-pump inhibitor developed as the S-isomer of omeprazole in an attempt to improve its pharmacokinetic properties. It was recently approved for children 1–17 years of age with GERD. Early detection and treatment of GERD in children may prevent, attenuate or heal complications, such as failure to thrive, feeding refusal and erosive esophagitis. Prospective, controlled, randomized studies conducted in children have shown esomeprazole to be well tolerated and an efficacious medication. The pharmacokinetics of esomeprazole in older children (1–17 years of age), such as bioavailability, elimination half-life and metabolism are similar to those in adults. As in adults, the bioavailability of esomeprazole increases from day 1 to day 5. Its adverse-effect profile in children is similar to that in adults.
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