Specifically I think of children on (1) NSAIDS, (2) systemic steroids, and (3) in critically ill children (i.e., stress ulcer prophylaxis)? What medications are recommended and which doses should be used? Does the start of a prophylaxis depend on (1) planned duration of the NSAIDs/steroid treatement (or do you start prophylaxis in any case?), (2) the dosages of NSAIDs/steroids applied, (3) the type of NSAIDS used, and (4) the presence of certain risk factors (like in adults)? However, if there are no widely acknowledged recommendations (I am afraid this is the case) how do you handle this problem in your hospital/department?
Dear Andreas, unaware of any evidence-based guideline, we are using PPI at 0.5-0.7(-1) mg/kg in all patients with more than 2 days high-dose glucocorticoid treatment. Intersting question. Best, m
I am not aware of any guidelines regarding the long term use of PPIs or H2 blockers in children. However, in our hospital, PPIs are used for treating GERD, gastric ulcers/bleeding and H.pylori eradication. For long tem use more than 8 weeks, we should be aware of the possible negative effect on calcium absorption and possible in crease risk of C.difficile infection.
Thank you for your answers. However, my question did not refer to the general use of PPI or H2 blockers in children. In contrast, I wanted to know your practice regarding the ulcer-prophylactic application of PPI, H2 blockers and sucralfate in children on steroids or NSAIDs.
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