{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T06:38:03Z","timestamp":1772347083534,"version":"3.50.1"},"reference-count":50,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,10,20]],"date-time":"2018-10-20T00:00:00Z","timestamp":1539993600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"National Institute of Health IGNITE Network"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Translational Sci"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The efficacy of proton pump inhibitor (PPI) medications is highly dependent on plasma concentrations, which varies considerably due to cytochrome P450 (<jats:italic><jats:bold>CYP2C19<\/jats:bold><\/jats:italic>) genetic variation. We conducted a pragmatic, pilot study of <jats:italic><jats:bold>CYP2C19<\/jats:bold><\/jats:italic> genotype\u2010guided pediatric dosing of PPI medications. Children aged 5\u201317\u00a0years old with gastric\u2010acid\u2010related conditions were randomized to receive either conventional dosing of a PPI or genotype\u2010guided dosing for a total of 12\u00a0weeks. Sixty children (30 in each arm) were enrolled and had comparable baseline characteristics. The mean daily omeprazole equivalent dose prescribed to participants across metabolizer phenotype groups was significantly different in the genotype\u2010guided dosing arm (<jats:italic><jats:bold>P<\/jats:bold><\/jats:italic>\u00a0&lt;\u00a00.001), but not in the conventional dosing arm. Prescribers waited for the genotype result before prescribing the PPI medication for 90% of the participants in the genotype\u2010guided dosing arm. The number of participants who reported an infection was marginally lower in genotype\u2010guided dosing vs. conventional dosing (20% vs. 44%; <jats:italic><jats:bold>P<\/jats:bold><\/jats:italic>\u00a0=\u00a00.07). Sinonasal symptoms were higher in the conventional dosing arm as compared with genotype\u2010guided dosing arm: (2.6 (2.0, 3.4) vs. 1.8 (1.0, 2.3), <jats:italic><jats:bold>P<\/jats:bold><\/jats:italic>\u00a0=\u00a00.031). <jats:italic><jats:bold>CYP2C19<\/jats:bold><\/jats:italic> genotype\u2010guided PPI therapy is feasible in a clinical pediatric setting, well accepted by providers, resulted in differential PPI dosing, and may reduce PPI\u2010associated infections. A future large scale randomized clinical trial of <jats:italic><jats:bold>CYP2C19<\/jats:bold><\/jats:italic> genotype\u2010guided pediatric dosing of PPI medications in children is warranted.<\/jats:p>","DOI":"10.1111\/cts.12589","type":"journal-article","created":{"date-parts":[[2018,10,20]],"date-time":"2018-10-20T15:29:21Z","timestamp":1540049361000},"page":"172-179","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Novel Implementation of Genotype\u2010Guided Proton Pump Inhibitor Medication Therapy in Children: A Pilot, Randomized, Multisite Pragmatic Trial"],"prefix":"10.1111","volume":"12","author":[{"given":"Emily J.","family":"Cicali","sequence":"first","affiliation":[{"name":"University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Blake","sequence":"additional","affiliation":[{"name":"Nemours Children's Specialty Care  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Gong","sequence":"additional","affiliation":[{"name":"University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward B.","family":"Mougey","sequence":"additional","affiliation":[{"name":"Nemours Children's Specialty Care  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hadeel","family":"Al\u2010Atrash","sequence":"additional","affiliation":[{"name":"Nemours Children's Hospital  Orlando Florida USA"},{"name":"University of Central Florida College of Medicine  Orlando Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Chambers","sequence":"additional","affiliation":[{"name":"Nemours Children's Hospital  Orlando Florida 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USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"Palomo","sequence":"additional","affiliation":[{"name":"Nemours Children's Hospital  Orlando Florida USA"},{"name":"University of Central Florida College of Medicine  Orlando Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salik","family":"Taufiq","sequence":"additional","affiliation":[{"name":"Nemours Children's Specialty Care  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie A.","family":"Johnson","sequence":"additional","affiliation":[{"name":"University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John J.","family":"Lima","sequence":"additional","affiliation":[{"name":"Nemours Children's Specialty Care  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James 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