Previously, this blog has noted an association between ranitidine usage and necrotizing enterocolitis (NEC) (see below). Now, another study provides insight into a potential mechanism (JPGN 2013; 56: 397-400).
This study examined the fecal microbiota in 76 premature infants who were enrolled in a case-controlled, cross-sectional study. 25 infants receiving H2-blockers were compared with 51 matched controls.
Results: microbial diversity was lower, relative abundance of Proteobacteria was increased, and Firmicutes was decreased in the stools of infants receiving H2-blockers.
While this study did not specifically examine the effect of H-2 blockers on NEC (no infants in this study had NEC), there are multiple reasons why the findings should be a cause for concern.
- Gastric acidity acts as a natural defense against bacterial growth and H-2 blockers (as well as proton pump inhibitors) inhibit this defense
- Previous studies have shown an association between NEC and with diminished microbial diversity/increased Proteobacteria. Proteobacteria include well-known pathogens like Klebsiella, Shigella, Escherichia coli, and Citrobacter.
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