Pharmacological Therapy of Gastroesophageal Reflux in Preterm Infants
Although gastroesophageal reflux (GER) is a very common phenomenon among preterm infants, its therapeutic management is still an issue of debate among neonatologists. A step-wise approach should be advisable, firstly promoting nonpharmacological interventions and limiting drugs to selected infants u...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2013/714564 |
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| author | Luigi Corvaglia Caterina Monari Silvia Martini Arianna Aceti Giacomo Faldella |
| author_facet | Luigi Corvaglia Caterina Monari Silvia Martini Arianna Aceti Giacomo Faldella |
| author_sort | Luigi Corvaglia |
| collection | DOAJ |
| description | Although gastroesophageal reflux (GER) is a very common phenomenon among preterm infants, its therapeutic management is still an issue of debate among neonatologists. A step-wise approach should be advisable, firstly promoting nonpharmacological interventions and limiting drugs to selected infants unresponsive to the conservative measures or who are suffering from severe GER with clinical complications. Despite of this, a concerning pharmacological overtreatment has been increasingly reported. Most of the antireflux drugs, however, have not been specifically assessed in preterm infants; moreover, serious adverse effects have been noticed in association to their administration. This review mainly aims to draw the state of the art regarding the pharmacological management of GER in preterm infants, analyzing the best piecies of evidence currently available on the most prescribed anti-reflux drugs. Although further trials are required, sodium alginate-based formulations might be considered promising; however, data regarding their safety are still limited. Few piecies of evidence on the efficacy of histamine-2 receptor blockers and proton pump inhibitors in preterm infants with GER are currently available. Nevertheless, a significantly increased risk of necrotizing enterocolitis and infections has been largely reported in association with their use, thereby leading to an unfavorable risk-benefit ratio. The efficacy of metoclopramide in GER’s improvement still needs to be clarified. Other prokinetic agents, such as domperidone and erythromycin, have been reported to be ineffective, whereas cisapride has been withdrawn due to its remarkable cardiac adverse effects. |
| format | Article |
| id | doaj-art-3282331910444aff8adc716d82e29c52 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-3282331910444aff8adc716d82e29c522025-02-03T05:57:07ZengWileyGastroenterology Research and Practice1687-61211687-630X2013-01-01201310.1155/2013/714564714564Pharmacological Therapy of Gastroesophageal Reflux in Preterm InfantsLuigi Corvaglia0Caterina Monari1Silvia Martini2Arianna Aceti3Giacomo Faldella4Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, via Massarenti 11, 40138 Bologna, ItalyNeonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, via Massarenti 11, 40138 Bologna, ItalyNeonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, via Massarenti 11, 40138 Bologna, ItalyNeonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, via Massarenti 11, 40138 Bologna, ItalyNeonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, via Massarenti 11, 40138 Bologna, ItalyAlthough gastroesophageal reflux (GER) is a very common phenomenon among preterm infants, its therapeutic management is still an issue of debate among neonatologists. A step-wise approach should be advisable, firstly promoting nonpharmacological interventions and limiting drugs to selected infants unresponsive to the conservative measures or who are suffering from severe GER with clinical complications. Despite of this, a concerning pharmacological overtreatment has been increasingly reported. Most of the antireflux drugs, however, have not been specifically assessed in preterm infants; moreover, serious adverse effects have been noticed in association to their administration. This review mainly aims to draw the state of the art regarding the pharmacological management of GER in preterm infants, analyzing the best piecies of evidence currently available on the most prescribed anti-reflux drugs. Although further trials are required, sodium alginate-based formulations might be considered promising; however, data regarding their safety are still limited. Few piecies of evidence on the efficacy of histamine-2 receptor blockers and proton pump inhibitors in preterm infants with GER are currently available. Nevertheless, a significantly increased risk of necrotizing enterocolitis and infections has been largely reported in association with their use, thereby leading to an unfavorable risk-benefit ratio. The efficacy of metoclopramide in GER’s improvement still needs to be clarified. Other prokinetic agents, such as domperidone and erythromycin, have been reported to be ineffective, whereas cisapride has been withdrawn due to its remarkable cardiac adverse effects.http://dx.doi.org/10.1155/2013/714564 |
| spellingShingle | Luigi Corvaglia Caterina Monari Silvia Martini Arianna Aceti Giacomo Faldella Pharmacological Therapy of Gastroesophageal Reflux in Preterm Infants Gastroenterology Research and Practice |
| title | Pharmacological Therapy of Gastroesophageal Reflux in Preterm Infants |
| title_full | Pharmacological Therapy of Gastroesophageal Reflux in Preterm Infants |
| title_fullStr | Pharmacological Therapy of Gastroesophageal Reflux in Preterm Infants |
| title_full_unstemmed | Pharmacological Therapy of Gastroesophageal Reflux in Preterm Infants |
| title_short | Pharmacological Therapy of Gastroesophageal Reflux in Preterm Infants |
| title_sort | pharmacological therapy of gastroesophageal reflux in preterm infants |
| url | http://dx.doi.org/10.1155/2013/714564 |
| work_keys_str_mv | AT luigicorvaglia pharmacologicaltherapyofgastroesophagealrefluxinpreterminfants AT caterinamonari pharmacologicaltherapyofgastroesophagealrefluxinpreterminfants AT silviamartini pharmacologicaltherapyofgastroesophagealrefluxinpreterminfants AT ariannaaceti pharmacologicaltherapyofgastroesophagealrefluxinpreterminfants AT giacomofaldella pharmacologicaltherapyofgastroesophagealrefluxinpreterminfants |