CRD Summary: This review assessed the efficacy, effectiveness and toxicity of metoclopramide for the treatment of gastroesophageal reflux disease (GERD) in infants. Given the small number of studies found, the lack of similarity between the included studies in terms of population, metoclopramide doses and outcomes, and the small sample sizes and lack of consistency in the literature, the authors' conclusion that there is insufficient evidence to support or oppose the use of metoclopramide for GERD in infants seems appropriate.

CRD Commentary: The review question was clearly supported in terms of the intervention, study design, outcome and population, though the definition of eligible population was somewhat broad ('infants') and is reflected in the study populations included in the review. Only one database was searched for studies and this was restricted to papers published in English; it is therefore possible that relevant studies were missed. The methods used for the study selection and data extraction processes were not reported, therefore the possibility of reviewer error or bias cannot be assessed at these stages. The validity of the individual studies does not appear to have been assessed. The studies differed in terms of patient populations, metoclopramide dosing and outcomes measured and, as such, a narrative synthesis was appropriate. The authors' statement that there is a lack of sufficient evidence to draw a robust conclusion seems appropriate.