Question 1: Does the use of ranitidine increase the risk of NEC in preterm infants?

Chandrasekaran, M; Fleming, Paul

doi:10.1136/archdischild-2013-304973

Cited by 3 publications

(4 citation statements)

References 14 publications

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“…Bilali et al in a case-control study that included 116 preterm infants with NEC reported that H2-blocker therapy was significantly associated with an increased incidence of NEC (30). Another evidence-based survey of Chandrasekaran and Fleming further confirmed that the use of ranitidine/H2 blockers is associated with an increased incidence of NEC (level 2b = individual cohort studies and low-quality randomized control trials) (31).…”

Section: Discussionmentioning

confidence: 97%

The Effects of Ranitidine Treatment on the Risk of Necrotizing Enterocolitis in Preterm Infants: A Case-Control Study

Zvizdić

Milišić

Jonuzi

et al. 2021

Acta Med. (Hradec Kralove, Czech Repub.)

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Introduction: Gastric acidity plays an important role in the protection of infants against various pathogens from the environment. The histamine-2 receptor blockers (H2-blockers) are off-labeled drugs that are frequently prescribed in preterm neonates to prevent stress ulcers. The impact of the H2-blockers on the development of the necrotizing enterocolitis (NEC) in preterm infants is still controversial, particularly in the developing world. Materials and Methods: One hundred twenty-two preterm infants were enrolled in the study. The multivariate logistic regression model was used to identify potential postnatal risk factors associated with NEC. Results: Preterm infants (n = 51) with total NEC, medical NEC, and surgical NEC had the highest rate of receiving ranitidine compared with controls (n = 71) (39.2%, 19.6%, and 47.6%, p < 0.05). Logistic regression analysis revealed that ranitidine use and nosocomial infections were significantly associated with NEC development (odds ratios 1.55 and 3.3). Conclusions: We confirm that ranitidine administration was associated with an increased risk of NEC in preterm infants. H2-blockers use should be only administered in very strictly selected cases after careful consideration of the risk-benefit ratio.

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Section: Discussionmentioning

confidence: 97%

The Effects of Ranitidine Treatment on the Risk of Necrotizing Enterocolitis in Preterm Infants: A Case-Control Study

Zvizdić

Milišić

Jonuzi

et al. 2021

Acta Med. (Hradec Kralove, Czech Repub.)

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“…A prospective study by Terrin et al [6] reported that ranitidine use in VLBW infants is associated with increased risk of infection, NEC, and mortality. This study, however, did not report on feeding type which is considered a potential independent risk factor for NEC [7]. This data was included in our study, with feeding types being comparable between exposed and non-exposed groups.…”

Section: Discussionmentioning

confidence: 99%

“…Antacids such as ranitidine and omeprazole are gastric acid secretion inhibitors and are commonly prescribed to preterm babies across neonatal intensive care units (NICUs) for management of reflux symptoms and GORD despite little evidence for efficacy and safety of their use in this age group [1, 3, 6, 7]. Prescription is in an off-labelled manner in preterm infants due to their perceived safety and possible benefits [3, 8–11].…”

Section: Introductionmentioning

confidence: 99%

Morbidity and Mortality in Preterm Infants following Antacid Use: A Retrospective Audit

Singh

Dhayade

Abdel-Latif

et al. 2016

International Journal of Pediatrics

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Background and Objectives. Antacids are often prescribed to preterm infants due to misdiagnosis of gastro-oesophageal reflux. This suppresses gastric acidity, a major defence mechanism against infection. This study aims to determine if ranitidine and omeprazole use in very low birth weight (VLBW) neonates, <1500 grams, is associated with increased risk of late onset sepsis, necrotising enterocolitis (NEC), and mortality. Methods. Retrospective analysis was conducted on neonates, <1500 grams, born and admitted into the Neonatal Intensive Care Unit at The Canberra Hospital during the period from January 2008 to December 2012. Information regarding late onset sepsis, NEC, mortality, ranitidine/omeprazole use, and other neonatal/hospital factors was collected for each neonate. Results. 360 neonates were evaluated, 64 received ranitidine and/or omeprazole, and 296 had not. There were no statistically significant differences in incidence of late onset sepsis (OR = 0.52, CI = 0.24–1.1, and p = 0.117), NEC Stage 2 and above (OR = 0.4, CI = 0.05–3.2, and p = 0.7), or mortality (OR = 0.35, CI = 0.08–1.5, and p = 0.19) between the two groups. After adjusting significant differences in neonatal and hospital factors, risk of late onset sepsis was significantly lower in those that received ranitidine/omeprazole (OR = 0.28, CI = 0.13–0.65, and p = 0.003). Conclusions. Ranitidine and omeprazole use in VLBW preterm infants may not be associated with an increased risk of infection, NEC, and mortality.

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“…14 The risk of NEC may also be increased by direct effects of H2-blockers on the immune system and decreased intestinal motility. 161,188 Prevention Quality improvement projects including scheduled feeding and the use of human milk, 189,190 conservative feeding guidelines during blood transfusions, and indomethacin treatment, and restrictive use of H2-blockers 190 seem to be able to reduce the incidence of NEC in institutions. As each program included a combination of preventive measures, it is, however, difficult to discern which ones had effect.…”

Section: Pathophysiologymentioning

confidence: 99%

Necrotising Enterocolitis - epidemiology and imaging

Ahle¹

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Question 1: Does the use of ranitidine increase the risk of NEC in preterm infants?

Cited by 3 publications

References 14 publications

The Effects of Ranitidine Treatment on the Risk of Necrotizing Enterocolitis in Preterm Infants: A Case-Control Study

The Effects of Ranitidine Treatment on the Risk of Necrotizing Enterocolitis in Preterm Infants: A Case-Control Study

Morbidity and Mortality in Preterm Infants following Antacid Use: A Retrospective Audit

Necrotising Enterocolitis - epidemiology and imaging

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