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Ranitidine and late-onset sepsis in the neonatal intensive care unit

  • Simona Bianconi , Madhu Gudavalli , Vesna G. Sutija , Anna L. Lopez , Lillian Barillas-Arias and Nitin Ron
Published/Copyright: March 7, 2007
Journal of Perinatal Medicine
From the journal Volume 35 Issue 2

Abstract

Aims: The objective of the study was to examine the effect of ranitidine on the incidence of late onset sepsis.

Methods: This study was based on information extracted from charts of 569 infants admitted to the neonatal intensive care unit (NICU) from July 2003 to July 2005. All infants admitted for seven or more days were included. Late-onset neonatal sepsis was defined as a positive blood culture with clinical signs of sepsis after seven days of life. Outcome measures included the use of ranitidine, type of infection and infectious agent, birth weight gestational age, and type of care in the NICU.

Results: Of the 569 infants admitted, 53 (9.3%) were treated with ranitidine. Of 74 infants who developed late-onset sepsis, 23 infants received ranitidine and 51 did not. Infants receiving ranitidine were at 7-times greater risk of late-onset sepsis (OR 6.99; 95% CI: 3.78–12.94; P<0.0001). The birth weights and gestational ages of infants with sepsis receiving ranitidine and those not receiving ranitidine were comparable, P=0.59.

Conclusion: The use of ranitidine in infants admitted to the NICU elevates the risk of late-onset sepsis. The pathological mechanisms need to be further studied. The safety of widespread use of ranitidine in neonates is controversial.

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Corresponding author: Madhu Gudavalli, MD Department of Pediatrics 506 Sixth Street Brooklyn, NY 11215, USA Tel: +1-718-780-5260

References

1 Beck-Sague CM, P Azimi, SN Fonseca, RS Baltimore, DA Powell, LA Bland, et al.: Bloodstream infections in neonatal intensive care unit patients: results of a multicenter study. Pediatr Infect Dis J13 (1994) 1110Search in Google Scholar

2 Cloherty JP, EC Eichenwald, AR Stark (eds): Manual of Neonatal Care. Lippincott Williams and Wilkins, Philadelphia 2004Search in Google Scholar

3 Cothran DS, SM Borowitz, JL Sutphen, SM Dudley, LG Donowitz: Alteration of normal gastric flora in neonates receiving ranitidine. J Perinatol17 (1997) 383Search in Google Scholar

4 Dinsmore JE, RJ Jackson, SD Smith: The protective role of gastric acidity in neonatal bacterial translocation. J Pediatr Surg32 (1997) 1014Search in Google Scholar

5 Graham PL, MD Begg, E Larson, P Della-Latta, A Allen, L Saiman: Risk factors for late onset gram-negative sepsis in low birth weight infants hospitalized in the neonatal intensive care unit. Pediatr Infect Dis J25 (2006) 113Search in Google Scholar

6 Guillet R, BJ Stoll, CM Cotton, M Gantz, S McDonald, WK Poole, et al.: Association of H2-blocker therapy and higher incidence of necrotizing enterocolitis in very low birth weight infants. Pediatrics117 (2006) e13710.1542/peds.2005-1543Search in Google Scholar

7 Hanisch EW, A Encke, F Naujoks, J Windolf: A randomized, double-blind trial for stress ulcer prophylaxis shows no evidence of increased pneumonia. Am J Surg176(1998) 45310.1016/S0002-9610(98)00239-6Search in Google Scholar

8 Jiang JH, NC Chiu, HA Kao, CH Hsu, HY Hung, JH Chang, et al.: Neonatal sepsis in the intensive care unit: characteristis of early verus late onset. J Microbiol Immul Infect/Chung Hua Min Kuo Hsiao Erh Ko I Hsueh Hui Tsa Chih37 (2004) 301Search in Google Scholar

9 Kuusela AL, T Ruuska, R Karikoski, P Laippala, RS Ikonen, M Janas, et al.: A randomized, controlled study of prophylactic ranitidine in preventing stress-induced gastric mucosal lesions in neonatal intensive care unit patients. Crit Care Med25 (1997) 346Search in Google Scholar

10 Lukacs SL, KC Shoendorf, A Schuchat: Trends in sepsis related neonatal mortality in the USA, 1985–1998. Pediatr Infect Dis J23 (2004) 599Search in Google Scholar

11 Messori A, S Trippoli, M Vaiani, M Gorini, A Corrado: Bleeding and pneumonia in intensive care patients given ranitidine and sucralfate for prevention of stress ulcer: meta-analysis of randomized controlled trials. Br Med J321 (2000) 1103Search in Google Scholar

12 Neu J, H Bernstein: Update on host defense and immunonutrients In: Berseth CL: Clinics In Perinatology, Recent Advances in Neonatal Gastroenterology. Saunders29(2002) 4110.1016/S0095-5108(03)00064-2Search in Google Scholar

13 Stoll BJ, N Hansen, AA Fanaroff, LL Wright, WA Carlo, RA Ehrenkranz, et al.: Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics110 (2002) 285Search in Google Scholar

14 Thorens J, F Froehlich, W Schwizer, E Saraga, L Bille, K Gyr, et al.: Bacterial overgrowth during treatment with omeprazole compared with cimetidine: a prospective randomized double blind study. Gut39 (1996) 54Search in Google Scholar

15 Weber JR, K Angstwurm, T Rosenkranz, U Lindauer, W Buerger, K Einhaeupl, et al.: Histamine receptor antagonist inhibits leukocyte rolling in pial vessels in the early phase of bacterial meningitis in rats. Neurosci Lett226 (1997) 17Search in Google Scholar

16 Yamaki K, H Thorlacius, X Xie, L Lindbom, P Hedqvist, J Raud: Characteristics of histamine-induced leukocyte rolling in the undisturbed microcirculation of the rat mesentery. Br J Pharmacology123 (1998) 390Search in Google Scholar

Published Online: 2007-03-07
Published in Print: 2007-04-01

©2007 by Walter de Gruyter Berlin New York

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