Evidence-Based Recommendation by Indian Pediatric Experts on the Use of Acid-Reducing Medications in Children
A recent Indian evidence-based review highlighted recommendations from a multidisciplinary team of paediatricians on the appropriate use of acid-reducing medications (ARMs) in children. The review was published in the July 2025 issue of the journalCureus. Gastric acid-reducing medications (ARMs), including H2 blockers and PPIs, are essential for treating various gastrointestinal conditions in pediatric care.However, concerns over safety and widespread off-label use persist, especially in younger children, due to lack of clear, practice-based prescribing guidelines. The Evidence-based review from Multidisciplinary team of Pediatricians on the use of gastric Acid-reducing medications in Children: Indian Perspectives (EMPACIP) study was undertaken to address these gaps by offering clear, evidence-based recommendations to guide appropriate ARM use and support informed prescribing in pediatric care. Twenty-four pediatric specialists, including neonatologists, general pediatricians, pediatric gastroenterologists, pediatric nephrologists, a pediatric hepatologist, a pediatric pulmonologist, and a pediatric intensivist from across India, conducted a structured literature review and collaboratively evaluated ARM use and current practices. They defined and assessed the severity of drug-induced dyspepsia using the ‘5-point Likert Scale Dyspepsia Severity Scale' via the Mentimeter platform.Among the various drug classes, NSAIDs and their combinations were identified as the most common cause of drug-induced dyspepsia, followed by Antibiotics like Amoxicillin/Clavulanic Acid, Azithromycin, Cefuroxime, Steroids like Prednisolone, and Nutritional supplements like Iron and Zinc supplements. The following are the recommendations provided: These findings aim to guide primary care practitioners in adopting evidence-based ARM practices, serving as a resource for current and future paediatricians to improve patient care. Reference:Pai UA, Ravishankar AV, Bharadia L, H R S, Wadhwa A, Prajapati B, C J, Mittal G, Belsare H, Anand K, Narayanan K, Furniturewala K, Sanklecha M, Suresh Kumar MV, Bhattacharya P, N P, Jog P, Wazir S, Soans ST, Manikanti SS, Roy S, Bhattacharyya S, Bansal U, Goswami V. Evidence-Based Review by a Multidisciplinary Team of Pediatricians on the Use of Gastric Acid-Reducing Medications in Children: Indian Perspectives. Cureus. 2025 May 7;17(5):e83653. doi: 10.7759/cureus.83653. PMID: 40486365; PMCID: PMC12143190.
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