Department of Pediatrics, University of Naples, Naples, Italy.
Curr Opin Gastroenterol. 2010 Jan;26(1):31-5. doi: 10.1097/MOG.0b013e328333d781.
We reviewed recent clinical studies performed in adults, children, and neonates exploring the possible association of gastric acidity inhibitors use with intestinal infections. Possible mechanisms have also been reported.
Many studies and systematic reviews demonstrate an increased risk of bacterial infection in adults taking acid suppressors. Little evidence is derived from the pediatric population. The use of gastric acidity inhibitors has been associated with systemic infections and necrotizing enterocolitis in preterm infants. Reduced gastric acidity, delayed gastric emptying, increased gastric mucus viscosity, modification in microbiota, and impairment of neutrophils functions, are all conditions determined by gastric acidity blockers that potentially lead to an increased risk of gastrointestinal infections.
A proper utilization of these drugs, particularly for patients at high risk, is imperative in order to reduce deleterious effects on infection risk and to optimize cost-effectiveness ratio.
我们综述了近期在成人、儿童和新生儿中进行的临床研究，探讨了胃酸抑制剂的使用与肠道感染的可能关联。也报道了可能的机制。
许多研究和系统评价表明，服用酸抑制剂的成年人发生细菌感染的风险增加。来自儿科人群的证据很少。胃酸抑制剂的使用与早产儿的全身感染和坏死性小肠结肠炎有关。胃酸减少、胃排空延迟、胃粘液粘度增加、微生物群改变以及中性粒细胞功能受损，这些都是胃酸阻滞剂引起的可能导致胃肠道感染风险增加的情况。
为了降低对感染风险的有害影响并优化成本效益比，这些药物的合理使用，特别是对高危患者，是至关重要的。
