Infant Reflux Acid-Suppression Treatment Increasing

Achler T, Chodick G, Shaoul R, Cohen S, Goldshtein I, Ben-Tov A. Trends and Correlates of Early-Life Exposure to Acid-Suppressant Therapy in Israel (2005-2020). J Pediatr. 2023;252:141-5. Among infants with gastroesophageal reflux (GER), what is the pattern of acid-suppression initiation from 2005 to 2020? Retrospective cohort study. Israel. Infants born between 2005 and 2020 who were enrolled in a large, state-mandated health fund (Maccabi Healthcare Services). Acid-suppressant therapy purchased during the first year of life. Incidence rates of acid-suppressant therapy usage per 1000 children per year. 22 412 infants (37.6 per 1000) initiated acid-suppressant therapy. The incidence rate increased from 18.2 per 1000 in 2005 to 51.0 per 1000 in 2020. Patient acid-suppressant-initiation age decreased over those 15 years. The percentage of primary care providers (PCPs) and gastroenterologists prescribing acid suppressants increased and decreased, respectively. Preterm birth and small for gestational age were associated with acid suppression usage. High socioeconomic status was linearly associated with initiation. Infant acid-suppressant initiation increased between 2005-20. Various associated factors may be intervention targets to reduce potential unnecessary acid suppression use.