A randomized clinical trial comparing ranitidine and antacids in critically ill patients.
In a randomized trial of gastric pH control for stress ulcer prophylaxis, 200 mg/day ranitidine iv was compared to antacids in 86 patients admitted to an ICU. Six (15%) patients receiving ranitidine and six (13%) given antacids failed to maintain greater than 50% of the hourly gastric pH measurements at or above 4. Increasing the ranitidine dosage to 300 mg/day did not provide additional control. One patient in the antacid group developed an overt upper GI bleed secondary to endoscopically proven erosive disease. We conclude that iv ranitidine in a dosage of 200 mg/day is as effective as antacids in reducing gastric acidity and preventing stress ulcer disease in critically ill patients.
Noseworthy
T W
TW
Shustack
A
A
Johnston
R G
RG
Anderson
B J
BJ
Konopad
E
E
Grace
M
M
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000536:Aluminum Hydroxide / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004338:Drug Combinations / Q000627:therapeutic use; D005260:Female; D005745:Gastric Acidity Determination; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007275:Injections, Intravenous; D007362:Intensive Care Units; D008274:Magnesium / Q000627:therapeutic use*; D008276:Magnesium Hydroxide / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000188:drug therapy*; D011897:Random Allocation; D011899:Ranitidine / Q000627:therapeutic use*; D013315:Stress, Psychological
D004338:Drug Combinations; C013591:aluminum hydroxide, magnesium hydroxide, drug combination; D000536:Aluminum Hydroxide; D011899:Ranitidine; D008274:Magnesium; D008276:Magnesium Hydroxide