Proton pump inhibitors in pediatrics.

For the past ten years or so, proton pump inhibitors (PPI) such as omeprazo le, lansoprazole, or pantoprazole, have become the reference treatment for peptic disorders in adults. PPIs have recently begun to be used in pediatri cs, and this use is likely to expand. They act on the final step of gastric acid secretion by completely inhibiting the ATPase (proton pump) at the su rface of the gastric parietal cells, thus yielding long term inhibition whi ch is not correlated with the plasma concentration of the drug, in contrast to the effects of H2-blocker drugs. Our knowledge of this new class of tre atment in pediatrics is still fragmentary, but the reported pharmacokinetic and clinical data indicate that they are suitable for use in children. Whi le the short-term risk of complications appears to be minimal, the toleranc e of these drugs in chronic use requires careful monitoring because of the potential consequences of prolonged inhibition of acid secretion. (C) 1999 Elsevier, Paris.