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

Zvizdic, Zlatan; Milisic, Emir; Jonuzi, Asmir; Terzic, Sabina; Zvizdic, Denisa; Vranic, Semir

doi:10.14712/18059694.2021.2

Acta Medica > Archive > 2021, Vol. 64 > Issue 1 > The Effects of Ranitidine Treatment on…

Acta Med. 2021, 64: 8-14

https://doi.org/10.14712/18059694.2021.2

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

Zlatan Zvizdic^a

, Emir Milisic^a, Asmir Jonuzi^a, Sabina Terzic^b, Denisa Zvizdic^c, Semir Vranic^d,e

^aClinic of Pediatric Surgery, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina
^bPediatric Clinic, Neonatal Intensive Care Unit, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina
^cEye Clinic, Department of Pediatric Ophthalmology, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina
^dBiomedical and Pharmaceutical Research Unit, QU Health, Qatar University, Doha, Qatar
^eCollege of Medicine, QU Health, Qatar University, Doha, Qatar

Received July 17, 2020
Accepted November 26, 2020

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.