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 .
Alteration of normal gastric flora in neonates receiving ranitidine.
OBJECTIVES To determine if the administration of ranitidine to neonates leads to an increase in gastric pH to > or = 4 and if this increase in gastric pH correlates with gastric colonization . STUDY DESIGN 628 pH measurements and 276 gastric cultures were obtained from 86 neonates . Twenty-three patients received ranitidine and 63 patients served as controls .  RESULTS Treated patients had a mean gastric pH of 5.6 compared with a control mean pH of 4.4 ( p < 0.0001 ) . Gastric pH was significantly affected by feeding and postnatal age . 54 patients were colonized with pathogenic bacteria and /or yeast ( n = 20 treated , n = 34 control ) . Length of hospitalization ( p < 0.0001 ) , increase in gastric pH ( p < 0.01 ) , days of antibiotics before culture ( p < 0.0001 ) , and ranitidine use ( p < 0.0001 ) were associated with an increased rate of colonization . CONCLUSIONS The use of ranitidine did lead to a significant increase in gastric pH and with this increase in gastric pH gastric colonization rates increased . No increased frequency of infection was found in ranitidine-treated infants
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 .