The Use of Omeprazole in Infants with Gastroesophageal Reflux-induced Wheezing

We evaluated the use of proton pump inhibitor omeprazole to control severe gastroesophageal reflux (GER) in two otherwise healthy infants (ages 4 and 7 months) presenting with respiratory symptoms only. Omeprazole was given when standard antireflux therapy (H2 receptor antagonists [H2RA] and prokinetic agents) for at least 6 weeks failed to improve the wheezing, and prolonged pH probe and infant pulmonary function tests failed to show any significant improvement. Within 6 weeks of omeprazole therapy the cough and wheezing had completely resolved. In otherwise healthy infants with refractory GER-induced wheezing, omeprazole therapy may avoid the need for fundoplication in some children and may be considered prior to any antireflux surgery. Prospective long-term studies in infants and children are warranted to establish safety for long-term use.