More evidence that ranitidine may contribute to necrotizing enterocolitis and fatal outcomes has been published (Pediatrics 2012; 129: e40-45).
In this study (which was reviewed in The Journal of Pediatrics 2012; 161: 168-69), four neonatal intensive care units in Italy performed a multicenter prospective observational study of very low birth weight (VLBW) inants. There were 274 neonates with gestational ages ranging from 24-32 weeks and birth weights ranging from 401-1500 grams. The patients receiving ranitidine were similar to the unexposed group in terms of risk factors for infection/NEC, birth weight, gestational age, sex, APGAR scores, PDA, intubation duration, and central vascular access duration.
- 34 of 91 (37%) exposed to ranitidine developed infections compared with 9.8% of the group not exposed to ranitidine (OR 5.5)
- Risk of necrotizing enterocolitis (NEC) was 6.6-fold higher among ranitidine-treated neonates
- Mortality was 9.9% for ranitidine-treated patients compared with 1.6% of control patients
Additional references/previous related blog entries:
- -Arch Surg 2010; 145: 143-6. Among appendicitis patients, ranitidine & diphenhidramine were associated with increased risk of abscess compared to children who did not receive these medicines (17% vs 10%). n=98.
- -Pediatrics 2006; 117: e137-42. Association of NEC with H2-blocker therapy in VLBW
- The Medical Pendulum and Gastroesophageal Reflux
- Potential and pitfalls of probiotics with necrotizing enterocolitis