Unanticipated Consequences of Proton Pump Inhibitor Use

This study investigates whether genetic variation in CYP2C19 contributes to proton pump inhibitor-associated infections and chronic illness exacerbations in children. Study aims include: 1) To compare rates of infection in healthy and obese children, and children with chronic illnesses of asthma and inflammatory bowel disease before and during treatment with proton pump inhibitors; 2) To determine the effect of proton pump inhibitor medications on rates of disease exacerbations among children with chronic illnesses of asthma and inflammatory bowel disease before and during treatment with proton pump inhibitors; and 3) Among children with existing DNA specimens, we will genotype a subsample for CYP2C19 metabolizer status and compare the rates of infection and disease exacerbations between poor vs. normal metabolizer phenotypes. This study will use a retrospective cohort design across PEDSnet participating institutions to identify otherwise healthy children as well as children with obesity, asthma and inflammatory bowel disease who have been prescribed PPI medications in the outpatient setting.