Quality statement 6: Acid‑suppressing drugs

Quality statement

Infants and children are not prescribed acid‑suppressing drugs if visible regurgitation is an isolated symptom.

Rationale

There is no evidence that acid‑suppressing drugs such as proton pump inhibitors (PPIs) or H2 receptor antagonists (H2RAs) are effective in reducing regurgitation in infants and children. They are generally well tolerated but do have potential adverse effects, and unnecessary use should be avoided.

Quality measures

Structure

Evidence of local arrangements to ensure that infants and children with regurgitation as an isolated symptom are not prescribed acid‑suppressing drugs.

Data source: Local data collection.

Process

Proportion of infants and children presenting with regurgitation as an isolated symptom prescribed acid‑suppressing drugs.

Numerator – number in the denominator prescribed acid‑suppressing drugs.

Denominator – number of infants and children presenting with regurgitation as an isolated symptom.

Data source: Local data collection.

Outcome

PPI and H2RA prescribing rates among infants and children.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers (secondary care, community care providers, GP practices) ensure that there are practice arrangements and written clinical protocols to ensure that infants and children with regurgitation as an isolated symptom are not prescribed acid‑suppressing drugs.

Healthcare professionals (midwives, paediatric nurses or GPs) do not prescribe acid‑suppressing drugs to infants and children with regurgitation as an isolated symptom.

Commissioners (clinical commissioning groups and NHS England) ensure that services they commission do not prescribe acid‑suppressing drugs to infants and children with regurgitation as an isolated symptom.

Infants and children who regurgitate food but have no other symptoms are not prescribed medicines that reduce acid production in the stomach.

Source guidance

Gastro-oesophageal reflux disease in children and young people (2015) NICE guideline NG1, recommendation 1.3.1 (key priority for implementation)

Definitions of terms used in this quality statement

Acid-suppressing drugs

Acid-suppressing drugs are a group of medications that reduce gastric acid secretion. They include H2RAs and PPIs.

[Gastro-oesophageal reflux disease in children and young people (2015) NICE full guideline NG1]