{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:25:54Z","timestamp":1786116354500,"version":"build-2736575974"},"reference-count":39,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Proton pump inhibitors (PPI) are frequently prescribed in infancy for functional gastrointestinal disorders such as colic and gastroesophageal reflux, despite limited evidence of benefit and potential risk. We aimed to examine the association between early PPI exposure and respiratory tract infections (RTIs) in a birth cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In the ARIES cohort (Santiago, Chile), 200 of 265 children with complete data were followed from birth to 24 months. Early PPI exposure was defined as any use during the first 6 months, while any exposure encompassed the first 24 months. Clinical data were collected via parental questionnaires and medical records. Associations were assessed using logistic regressions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixteen infants (8%) received PPIs during the first 6 months and 22 (11%) during the first 2 years. By age two, otitis media occurred in 12%, viral croup in 18%, bronchiolitis in 36%, pneumonia in 2.5%, RTI\u2010related hospitalization in 3%, and RTI\u2010related antibiotic use in 38%. Early PPI exposure was independently associated with otitis media (adjusted odds ratio [aOR] 9.5, 95% CI 2.1\u221242.5), viral croup (aOR 4.8, 95% CI 1.5\u221215.2), RTI\u2010related hospitalization (aOR 19.3, 95% CI 1.6\u2212225.8), and antibiotic use (aOR 9.9, 95% CI 2.5\u221238.6). Any PPI exposure also increased odds of otitis media (aOR 5.4, 95% CI 1.4\u221221.0), viral croup (aOR 3.0, 95% CI 1.1\u22128.1), RTI\u2010related hospitalization (aOR 17.5, 95% CI 1.5\u2212205.0), and antibiotic use (aOR 8.9, 95% CI 2.9\u221227.1). No significant associations were observed with lower RTIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early PPI exposure in infancy is associated with higher risk of upper RTIs, RTI\u2010related hospitalization and antibiotic prescriptions. These findings underscore the importance of cautious PPI prescribing in early life, a critical period for immune and microbiota development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71715","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T14:40:51Z","timestamp":1782484851000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Use of Proton Pump Inhibitors Increases Risk of Upper Respiratory Tract Infections in Children: A Birth Cohort Study"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2677-815X","authenticated-orcid":false,"given":"Maite","family":"Rojas\u2010McKenzie","sequence":"first","affiliation":[{"name":"Department of Pediatric Infectious Diseases and Immunology, School of Medicine Pontificia Universidad Cat\u00f3lica de Chile Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2122-7899","authenticated-orcid":false,"given":"Juan P.","family":"Fraga","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases and Immunology, School of Medicine Pontificia Universidad Cat\u00f3lica de Chile Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8299-3864","authenticated-orcid":false,"given":"Carolina","family":"Iturriaga","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases and Immunology, School of Medicine Pontificia Universidad Cat\u00f3lica de Chile Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5758-9141","authenticated-orcid":false,"given":"Caroll","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases and Immunology, School of Medicine Pontificia Universidad Cat\u00f3lica de Chile Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8926-8756","authenticated-orcid":false,"given":"Guillermo","family":"P\u00e9rez\u2010Mateluna","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases and Immunology, School of Medicine Pontificia Universidad Cat\u00f3lica de Chile Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela","family":"Urz\u00faa","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases and Immunology, School of Medicine Pontificia Universidad Cat\u00f3lica de Chile Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5523-0637","authenticated-orcid":false,"given":"Carolina A.","family":"Serrano","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition, School of Medicine Pontificia Universidad Cat\u00f3lica de Chile Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2355-1476","authenticated-orcid":false,"given":"Paola","family":"Casanello","sequence":"additional","affiliation":[{"name":"Department of Neonatology, School of Medicine Pontificia Universidad Cat\u00f3lica de Chile Santiago Chile"},{"name":"Department of Obstetrics, School of Medicine Pontificia Universidad Cat\u00f3lica de Chile Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6226-0957","authenticated-orcid":false,"given":"Paul R.","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition, School of Medicine Pontificia Universidad Cat\u00f3lica de Chile Santiago Chile"},{"name":"Red de Salud UC CHRISTUS Santiago 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