The role of H2 blockers and proton pump inhibitors in treatment of gastroesophageal reflux disease in children
Abstract
For infants from 1 month to 1 year of age can be proven in esophagitis erotivní indicate treatment with esomeprazole. H2 blockers (H2RA) can be used to treat symptoms of reflux disease in children, but they are not suitable for prolonged use (> 6 weeks) due to tachyphylaxis and development of tolerance.
Probably no significant difference in effectiveness between H2RA preparations. Proton pump inhibitors (PPI) are more effective than H2RA treatment of oesophagitis and in influencing symptoms, their effect is maintained long term.
PPI is usually administered in a single dose 15-30 minutes before breakfast. Children aged 1 to 10 years of age require higher doses of PPI per kg (0.7-2 mg / kg / day, with a maximum of 3.3 mg / kg / day) than adolescents and adults.
Infants under 6 months of age in need of lower doses of PPI (0.7 to 1.2 mg / kg / day) per kg weight than older children and adolescents. Pharmacotherapy should be given to the possible adverse effects carefully considered.
Serious side effects of PPIs include: community-acquired pneumonia, viral diarrhea, candidemia, necrotizing enterocolitis in preterm infants