Proton Pump Inhibitors in Children: the Good, the Bad, and the Ugly


Purpose of Review

The evidence supporting or contesting the prescription of proton pump inhibitors (PPIs) for children and updates on side effects are reviewed.

Recent Findings

PPIs remain an important therapeutic option for esophagitis and gastritis. However, recent studies demonstrate no benefit when prescribing PPIs for chronic cough, infantile reflux, asthma, or functional gastrointestinal disorders. Recent studies suggest adverse effects on microbiome diversity and immune function, resulting in increased rates of gastrointestinal infections, bone fractures, and atopic disorders. PPIs influence a variety of cell types within the in the innate and adaptive immune systems.


PPI prescriptions in children may be indicated for select conditions; however, multiple side effects and immune effects have been described. While most of these side effects are rare and mild, some studies suggest enduring adverse effects. Future studies to elucidate the mechanism behind some of these immune and infectious complications will be beneficial.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Correspondence to Cade M. Nylund.

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This work was prepared as part of the official duties of Drs. Pasman, Witmer, Ong, and Nylund, who are employed by the United States Navy, Army, and Air Force. The views expressed in this article are those of the authors and do not reflect the official policy or position of the United States Navy, Army, Air Force, Department of Defense, The Uniformed Services of the Health Sciences or the United States Government.

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Pasman, E.A., Ong, B., Witmer, C.P. et al. Proton Pump Inhibitors in Children: the Good, the Bad, and the Ugly. Curr Allergy Asthma Rep 20, 39 (2020).

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  • Proton pump inhibitor
  • Children
  • Allergy
  • Immunology
  • Side effects