Use of ranitidine is associated with infections in newborns hospitalized in a neonatal intensive care unit: a cohort studyReportar como inadecuado

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BMC Infectious Diseases

, 17:375

Viral diseases


BackgroundThe inhibition of gastric acid secretion with ranitidine is frequently prescribed off-label to newborns admitted to neonatal intensive care units NICU. Some studies show that the use of inhibitors of gastric acid secretion IGAS may predispose to infections and necrotising enterocolitis NEC, but there are few data to confirm this association. This study aimed to compare the rates of neonatal infections and NEC among preterm infants <37 weeks gestation hospitalised in a NICU exposed or not to treatment with ranitidine.

MethodsA retrospective cohort study was conducted with all consecutive preterm newborns admitted to a NICU between August-2014 and October-2015. The rates of infection, NEC, and death of newborns exposed or not to ranitidine were recorded.

ResultsA total of 300 newborns were enrolled, of which 115 had received ranitidine and 185 had not. The two groups were similar with regard to the main demographic and clinical characteristics. Forty-eight 41.7% of the 115 infants exposed to ranitidine and 49 26.5% of the 185 infants not exposed were infected RR = 1.6, 95%CI 1.1–2.2, p = 0.006. The late onset >48 h blood culture positive infection rate was higher in the group exposed to ranitidine than in the untreated group 13.0% vs. 3.8%, p = 0.001. There was no significant association between the use of ranitidine and NEC Bell stage >II p = 0.36. The mortality rate risk was 4-fold higher in infants receiving ranitidine 16.5% vs. 8.6%, p < 0.001.

ConclusionRanitidine use in neonates was associated with an increased risk of infections and mortality, but not with NEC.

KeywordsRanitidine Neonates Infection Necrotising enterocolitis Mortality AbbreviationsCCPICentral catheter peripherally inserted

GERDGastroesophageal reflux disease

IGASInhibitors of gastric acid secretion

MVMechanical ventilation

NECNecrotising enterocolitis

NICUNeonatal intensive care units

NSLMNossa Senhora de Lourdes Maternity

OTOrogastric tube

PNParenteral nutrition

UCUmbilical catheter

UTIUrinary tract infection

Electronic supplementary materialThe online version of this article doi:10.1186-s12879-017-2482-x contains supplementary material, which is available to authorized users.

Autor: Ruth N. S. Santana - Victor S. Santos - Ruy F. Ribeiro-Júnior - Marina S. Freire - Maria A. S. Menezes - Rosana Cipo


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