Exposure to H2 receptor antagonists may be associated with increased risk of NEC and infections in preterm infants
BACKGROUND Inhibitors of gastric acid ( IGA ) are used for upper gastrointestinal bleeding or gastroesophageal reflux in preterm infants .
The result ant increase in gastric pH may enhance the growth of pathogens and increase the risk of necrotizing enterocolitis ( NEC ) .
Our systematic review examined the association between  IGA and NEC in preterm infants .
Single-dose, multiple-dose, and population pharmacokinetics of pantoprazole in neonates and preterm infants with a clinical diagnosis of gastroesophageal reflux disease (GERD)
Purpose The pharmacokinetic profile of pantoprazole granules was assessed in neonates and preterm infants with gastroesophageal reflux disease ( GERD ) in a multicenter , r and omized , open-label trial . Methods Patients were r and omly assigned to either the pantoprazole 1.25 mg ( approx . 0.6 mg/kg ) or 2.5 mg ( approx . 1.2-mg/kg ) group and treated for ≥5 consecutive days . Blood was sample d either at 0 , 2 , 8 , and 18 h postdose or at 0 , 1 , 4 , and 12 h postdose on day 1 and at 3 and 6 h postdose after ≥5 consecutive doses . Cytochrome P450 2C19 ( CYP2C19 ) and CYP3A4 genotypes were determined . Safety was monitored . Population pharmacokinetics ( popPK ) analyses were conducted using nonlinear mixed-effects modeling . Results The popPK modeling of the pantoprazole 1.25 mg and 2.5 mg groups obtained mean ( ±st and ard deviation ) estimates for the area under the plasma concentration versus time curve ( AUC ) of 3.54 ( ±2.82 ) and 7.27 ( ±5.30 ) µg h/mL , respectively , and mean estimates for half-life of 3.1 ( ±1.5 ) and 2.7 ( ±1.1 ) h , respectively . Pantoprazole did not accumulate following multiple-dose administration . The two patients with the CYP2C19 poor metabolizer genotype had a substantially higher AUC than extensive metabolizers . No safety-related discontinuations occurred . Conclusions In preterm infants and neonates , pantoprazole granules were generally well tolerated , mean exposures with pantoprazole 2.5 mg were slightly higher than that in adults who received 40 mg . While the half-life was longer , accumulation did not occur
Exposure to H2 receptor antagonists may be associated with increased risk of NEC and infections in preterm infants
BACKGROUND Inhibitors of gastric acid ( IGA ) are used for upper gastrointestinal bleeding or gastroesophageal reflux in preterm infants .
The result ant increase in gastric pH may enhance the growth of pathogens and increase the risk of necrotizing enterocolitis ( NEC ) .
Our systematic review examined the association between  IGA and NEC in preterm infants .