Histamine-2-Receptor Antagonists and Antacids in the Critically Ill Population: Stress Ulceration versus Nosocomial Pneumonia

Abstract

We performed a meta-analysis to evaluate whether stress ulcer prophylaxis with histamine-2-receptor antagonists or antacids reduces mortality in critically ill patients. It appears that sucralfate results in a lower incidence of nosocomial pneumonia than either antacids or histamine-2-receptor antagonists. With respect to mortality, strong trends favored sucralfate over both antacids and histamine-receptor antagonists.

Lessons from Meta‐analysis: The Case of Albumin

“…The conclusions from these reviews and studies are that H 2 -antagonists prevent stress ulceration, probably better than sucralfate, and that while sucralfate was associated with less pneumonia than H 2 -antagonists in 1992, that trend is no longer significant, and maybe there is very little difference. The net result from these two areas of reviews is that H 2 -antagonists reduce stress ulceration and that systematic reviews do generate a vast amount of interest [31][32][33][34][35][36][37][38][39] . Is this level of evidence worth the effort of acquiring it?…”