Nosocomial Pneumonia During Stress Ulcer Prophylaxis With Cimetidine and Sucralfate

Ryan, Patrick B.; Dawson, John; Teres, Daniel; Celoria, Giovanni; Navab, Farhad

doi:10.1001/archsurg.1993.01420240061011

Cited by 46 publications

(16 citation statements)

References 19 publications

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“…In our study, there was no significant difference in the frequency of pneumonia in different groups; however, we have not measured gastric pH. In a randomized study, the incidence of pneumonia in cimetidine group was 12.5% and in sucralfate group 13.8% which was in agreement with our observation [15] which is in conformity with the results of a meta-analysis as well [7]. In an earlier study, higher frequency of pneumonia in ranitidine group compared to sucralfate was reported and ranitidine was used in a dose of 50 mg six hourly [11].…”

Section: Groupsupporting

confidence: 90%

See 1 more Smart Citation

A randomized placebo controlled trial of ranitidine versus sucralfate in patients with spontaneous intracerebral hemorrhage for prevention of gastric hemorrhage

Misra

Pandey

Mandal

et al. 2005

Journal of the Neurological Sciences

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Section: Groupsupporting

confidence: 90%

“…In the available literature, we have not come across any report highlighting such vulnerability of males for stress ulcer bleeding. In several studies on stress ulcer, the gender differences in gastric ulcer patients were not reported [6,12,14,15]. Peptic ulcers are also more common in males (6.2%) compared to females (2.8%) [16].…”

Section: Groupmentioning

confidence: 99%

A randomized placebo controlled trial of ranitidine versus sucralfate in patients with spontaneous intracerebral hemorrhage for prevention of gastric hemorrhage

Misra

Pandey

Mandal

et al. 2005

Journal of the Neurological Sciences

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“…Several lines of evidence point to the bio - Yildizdas et al 45 Maier et al 37 O'Keefe et al 44 Misra et al 47 Driks et al 26 Pickworth et al 33 Martin et al 31 Eddleston et al 29 Prod'hom et al 38 Ben-Menachem et al 35 Apte et al 30 Cloud et al 36 Moesgaard et al 43 Ryan et al 34 Kantorova et al 46 Laggner et al 27 Cheadle et al 25 Hanisch et al 42 Reusser et al 28 Cook et al 41 Metz et al 32 Thomason et al logical plausibility of these observations. First, acid-suppressive drugs may increase the risk of pneumonia by inhibiting the secretion of gastric acid, thus allowing bacterial overgrowth and colonization in the upper alimentary tract and subsequent translocation to the lungs by aspiration.…”

Section: Main Findingsmentioning

confidence: 99%

Use of acid-suppressive drugs and risk of pneumonia: a systematic review and meta-analysis

Eom¹,

Jeon²,

Lim³

et al. 2010

Canadian Medical Association Journal

354

222

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Background: Observational studies and randomized controlled trials have yielded inconsistent findings about the association between the use of acid-suppressive drugs and the risk of pneumonia. We performed a systematic review and meta-analysis to summarize this association. Methods:We searched three electronic databases (MEDLIN E [PubMed], Embase and the Cochrane Library) from inception to Aug. 28, 2009. Two evaluators independently extracted data. Because of heterogeneity, we used random-effects meta-analysis to obtain pooled estimates of effect. Results:We identified 31 studies: five casecontrol studies, three cohort studies and 23 randomized controlled trials. A meta-analysis of the eight observational studies showed that the overall risk of pneumonia was higher among people using proton pump inhibitors (adjusted odds ratio [OR] 1.27, 95% confidence interval [CI] 1.11-1.46, I 2 90.5%) and histamine 2 receptor antagonists (adjusted OR 1.22, 95% CI 1.09-1.36, I 2 0.0%). In the randomized controlled trials, use of histamine 2 receptor antagonists was associated with an elevated risk of hospital-acquired pneumonia (relative risk 1.22, 95% CI 1.01-1.48, I 2 30.6%).Interpretation: Use of a proton pump inhibitor or histamine 2 receptor antagonist may be associated with an increased risk of both community-and hospital-acquired pneumonia. Given these potential adverse effects, clinicians should use caution in prescribing acid-suppressive drugs for patients at risk.

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“…[6] To prevent from stress ulcer, anti reflux and antacids are administered for ICU patients, two of which are sucralfate and pantoprazole. [7] Sucralfate covers the stomach mucosa and prevents movement of bacteria toward pharynx and lungs. Pantoprazole inhibits proton pump, and prevents acid secretion.…”

Section: Introductionmentioning

confidence: 99%

The comparison between proton pump inhibitors and sucralfate in incidence of ventilator associated pneumonia in critically ill patients

et al. 2014

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Background:Ventilator associated pneumonia (VAP) are one of the most common nosocomial infections in intensive care unit (ICU). The ICU patients are at risk of stress ulcer and gastrointestinal bleeding for different reasons. In order to prevent this complication, anti acids are used for patients. This study compared pantoprazole with sucralfate in incidence of ventilator associated pneumonia.Materials and Methods:This randomized clinical trial was carried out on ICU patients with mechanical ventilation in Alzahra university hospital in Isfahan from 2010 to 2011. One hundred forty eight ventilated patients were randomly allocated in two groups. The first group was treated with sucralfate and the second group was treated with pantoprazole for stress ulcer prophylaxis and followed up during hospitalization in ICU for nosocomial pneumonia. Data analyzed by SPSS software.Results:One hundred thirty seven patients were selected for study. During the study period, 34 cases (24.8%) acquired pneumonia, of which 10 were in the sucralfate group and 24 were in the pantoprazole group (14.1% vs. 36.4%). According to Chi-square test, rate of pneumonia was significantly lower in patients receiving sucralfate than the pantoprazole group (P < 0.001).Conclusion:On the basis of the results, there is a significant relationship between the kind of drug used for stress ulcer and ventilator associated pneumonia. According to this article, rate of pneumonia was significantly lower in patients receiving sucralfate than the pantoprazole group.

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Nosocomial Pneumonia During Stress Ulcer Prophylaxis With Cimetidine and Sucralfate

Abstract: These observations suggest that the rate of nosocomial pneumonia is not increased in patients in the intensive care unit who receive prophylaxis with cimetidine to prevent stress ulcer bleeding.

Cited by 46 publications

References 19 publications

A randomized placebo controlled trial of ranitidine versus sucralfate in patients with spontaneous intracerebral hemorrhage for prevention of gastric hemorrhage

A randomized placebo controlled trial of ranitidine versus sucralfate in patients with spontaneous intracerebral hemorrhage for prevention of gastric hemorrhage

Use of acid-suppressive drugs and risk of pneumonia: a systematic review and meta-analysis

The comparison between proton pump inhibitors and sucralfate in incidence of ventilator associated pneumonia in critically ill patients

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