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 .
Nosocomial pneumonia risk and stress ulcer prophylaxis: a comparison of pantoprazole vs ranitidine in cardiothoracic surgery patients.
BACKGROUND Stress ulcer prophylaxis ( SUP ) using ranitidine , a histamine H2 receptor antagonist , has been associated with an increased risk of ventilator-associated pneumonia . The proton pump inhibitor ( PPI ) pantoprazole is also commonly used for SUP . PPI use has been linked to an increased risk of community-acquired pneumonia . The objective of this study was to determine whether SUP with pantoprazole increases pneumonia risk compared with ranitidine in critically ill patients . METHODS The cardiothoracic surgery data base at our institution was used to identify retrospectively all patients who had received SUP with pantoprazole or ranitidine , without crossover between agents . From January 1 , 2004 , to March 31 , 2007 , 887 patients were identified , with 53 patients excluded ( pantoprazole , 30 patients ; ranitidine , 23 patients ) . Our analysis compared the incidence of nosocomial pneumonia in 377 patients who received pantoprazole with 457 patients who received ranitidine .  RESULTS Nosocomial pneumonia developed in 35 of the 377 patients ( 9.3 % ) who received pantoprazole , compared with 7 of the 457 patients ( 1.5 % ) who received ranitidine ( odds ratio [ OR ] , 6.6 ; 95 % confidence interval [ CI ] , 2.9 to 14.9 ) . Twenty-three covariates were used to estimate the probability of receiving pantoprazole as measured by propensity score ( C-index , 0.77 ) . Using this score , pantoprazole and ranitidine patients were stratified according to their probability of receiving pantoprazole . After propensity adjusted , multivariable logistic regression , pantoprazole treatment was found to be an independent risk factor for nosocomial pneumonia ( OR , 2.7 ; 95 % CI , 1.1 to 6.7 ; p = 0.034 ) . CONCLUSION The use of pantoprazole for SUP was associated with a higher risk of nosocomial pneumonia compared with ranitidine . This relationship warrants further study in a r and omized controlled trial
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 .