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 .
Bloodstream infections in neonatal intensive care unit patients: results of a multicenter study.
For identification of risk factors for bloodstream infection ( BSI ) among neonatal intensive care unit patients , prospect i ve 6-month studies in three neonatal intensive care units were conducted . BSI was diagnosed in 42 of 376 ( 11.2 % ) enrolled infants . Pathogens included coagulase-negative staphylococci , C and ida sp. , Group B streptococci and Gram-negative species . Patients with BSIs were more likely to die during their neonatal intensive care unit stay than were patients who did not acquire BSIs ( 6 of 42 vs. 11 of 334 , P = 0.007 ) . BSI rate was highest in infants with birth weight < 1500 g ( relative risk ( RR ) = 6.8 , P < 0.001 ) , those treated with H-2 blockers ( RR = 4.2 , P < 0.001 ) or theophylline ( RR = 2.8 , P < 0.001 ) and those with admission diagnoses referable to the respiratory tract ( RR = 3.7 , P < 0.001 ) . Infants who developed BSI were more severely ill on admission than other infants ( median physiologic stability index 13 vs. 10 ( P < 0.001 ) and were of lower gestational age ( 28 vs. 35 weeks , P < 0.001 ) . In logistic regression analysis , risk of BSI was independently associated only with very low birth weight , respiratory admission diagnoses and receipt of H-2 blockers . Risk of isolation of a pathogen from blood culture was independently associated with Broviac , umbilical vein or peripheral venous catheterization > 10 , 7 or 3 days , respectively , at one insertion site . Rate of isolation of a pathogen was higher ( 9 of 59 ( 15 % ) ) within 48 hours of a measurable serum interleukin 6 concentration than an interleukin 6 level of 0 pg/ml ( 10 of 159 ( 6 % ) , P = 0.04 ) . ( ABSTRACT TRUNCATED AT 250 WORDS
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 .