BACKGROUND AND OBJECTIVES: Gastric acidity is a major nonimmune defense mechanism against infections. The objective of this study was to investigate whether ranitidine treatment in very low birth weight (VLBW) infants is associated with an increased risk of infections, necrotizing enterocolitis (NEC), and fatal outcome. METHODS: Newborns with birth weight between 401 and 1500 g or gestational age between 24 and 32 weeks, consecutively observed in neonatal intensive care units, were enrolled in a multicenter prospective observational study. The rates of infectious diseases, NEC, and death in enrolled subjects exposed or not to ranitidine were recorded. RESULTS: We evaluated 274 VLBW infants: 91 had taken ranitidine and 183 had not. The main clinical and demographic characteristics did not differ between the 2 groups. Thirty-four (37.4%) of the 91 children exposed to ranitidine and 18 (9.8%) of the 183 not exposed to ranitidine had contracted infections (odds ratio 5.5, 95% confidence interval 2.9-10.4, P < .001). The risk of NEC was 6.6-fold higher in ranitidine-treated VLBW infants (95% confidence interval 1.7-25.0, P = .003) than in control subjects. Mortality rate was significantly higher in newborns receiving ranitidine (9.9% vs 1.6%, P = .003). CONCLUSIONS: Ranitidine therapy is associated with an increased risk of infections, NEC, and fatal outcome in VLBW infants. Caution is advocated in the use of this drug in neonatal age. Pediatrics 2012; 129: e40-e45

Ranitidine is Associated With Infections, Necrotizing Enterocolitis, and Fatal Outcome in Newborns / Terrin, Gianluca; A., Passariello; DE CURTIS, Mario; F., Manguso; G., Salvia; L., Lega; Francesco, Messina; R., Paludetto; R., Berni Canani. - In: PEDIATRICS. - ISSN 0031-4005. - STAMPA. - 129:1(2012), pp. E40-E45. [10.1542/peds.2011-0796]

Ranitidine is Associated With Infections, Necrotizing Enterocolitis, and Fatal Outcome in Newborns

TERRIN, GIANLUCA;DE CURTIS, MARIO;
2012

Abstract

BACKGROUND AND OBJECTIVES: Gastric acidity is a major nonimmune defense mechanism against infections. The objective of this study was to investigate whether ranitidine treatment in very low birth weight (VLBW) infants is associated with an increased risk of infections, necrotizing enterocolitis (NEC), and fatal outcome. METHODS: Newborns with birth weight between 401 and 1500 g or gestational age between 24 and 32 weeks, consecutively observed in neonatal intensive care units, were enrolled in a multicenter prospective observational study. The rates of infectious diseases, NEC, and death in enrolled subjects exposed or not to ranitidine were recorded. RESULTS: We evaluated 274 VLBW infants: 91 had taken ranitidine and 183 had not. The main clinical and demographic characteristics did not differ between the 2 groups. Thirty-four (37.4%) of the 91 children exposed to ranitidine and 18 (9.8%) of the 183 not exposed to ranitidine had contracted infections (odds ratio 5.5, 95% confidence interval 2.9-10.4, P < .001). The risk of NEC was 6.6-fold higher in ranitidine-treated VLBW infants (95% confidence interval 1.7-25.0, P = .003) than in control subjects. Mortality rate was significantly higher in newborns receiving ranitidine (9.9% vs 1.6%, P = .003). CONCLUSIONS: Ranitidine therapy is associated with an increased risk of infections, NEC, and fatal outcome in VLBW infants. Caution is advocated in the use of this drug in neonatal age. Pediatrics 2012; 129: e40-e45
2012
gastric acidity inhibitors; sepsis; urinary tract infections; histamine-2 receptor antagonists; very low birth weight; microflora; pneumonia
01 Pubblicazione su rivista::01a Articolo in rivista
Ranitidine is Associated With Infections, Necrotizing Enterocolitis, and Fatal Outcome in Newborns / Terrin, Gianluca; A., Passariello; DE CURTIS, Mario; F., Manguso; G., Salvia; L., Lega; Francesco, Messina; R., Paludetto; R., Berni Canani. - In: PEDIATRICS. - ISSN 0031-4005. - STAMPA. - 129:1(2012), pp. E40-E45. [10.1542/peds.2011-0796]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/392567
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