Clinica Pediatrica, IRCCS “Burlo Garofolo”, Trieste
Indirizzo per corrispondenza: firstname.lastname@example.org
Key words: Antacids, Proton pump inhibitors (PPI), Children, Guidelines
In Italy proton pump inhibitors PPI are, certainly, too often prescribed just to prevent gastric bleedings caused by NSAIDs or steroids; besides, other drugs are prescribed to relieve symptoms or to make a diagnosis ex-juvantibus in patients with suspected gastroesophageal reflux disease. The following guidelines highlight the correct and commonly shared indications. Formal indications are related to: gastric or gastrointestinal ulcer; gastroesophageal reflux disease; the prevention of serious complications in the upper gastrointestinal tract in patients under long-term treatment with NSAIDs or antiplatelet treatment with ASA, only in presence of risk factors such as old age, associated therapy with anticoagulant or cortisone drugs and previous digestive haemorrhage. The prescription of antacids concerns patients of any age, hospitalised in intensive-care units and at risk of stressinduced gastropathy. Cortisone treatment, anticoagulant or antiblastic therapies are not sufficient indications to provide gastroprotection with antacids especially in children, whose risk of gastric lesion caused by these drugs is minimal, and not even statistically evaluated; moreover, the preventive effect of antacids has never been systematically studied. An antacid prophylaxis is not formally prescribed to children even in case of prolonged treatment with NSAIDs if risk factors are absent.
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