Alteration of normal gastric flora in neonates receiving ranitidine.
OBJECTIVE
To determine if the administration of ranitidine to neonates leads to an increase in gastric pH to > or = 4 and if this increase in gastric pH correlates with gastric colonization.


METHODS
628 pH measurements and 276 gastric cultures were obtained from 86 neonates. Twenty-three patients received ranitidine and 63 patients served as controls.


RESULTS
Treated patients had a mean gastric pH of 5.6 compared with a control mean pH of 4.4 (p < 0.0001). Gastric pH was significantly affected by feeding and postnatal age. 54 patients were colonized with pathogenic bacteria and/or yeast (n = 20 treated, n = 34 control). Length of hospitalization (p < 0.0001), increase in gastric pH (p < 0.01), days of antibiotics before culture (p < 0.0001), and ranitidine use (p < 0.0001) were associated with an increased rate of colonization.


CONCLUSIONS
The use of ranitidine did lead to a significant increase in gastric pH and with this increase in gastric pH gastric colonization rates increased. No increased frequency of infection was found in ranitidine-treated infants.
Cothran
D S
DS
Division of Neonatology, Children's Hospital, Omaha, Neb., USA.
Borowitz
S M
SM
Sutphen
J L
JL
Dudley
S M
SM
Donowitz
L G
LG
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003428:Cross Infection / Q000453:epidemiology; D005260:Female; D005745:Gastric Acidity Determination; D006635:Histamine H2 Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007902:Length of Stay; D008297:Male; D011899:Ranitidine / Q000494:pharmacology / Q000627:therapeutic use*; D013270:Stomach / Q000382:microbiology*; D013276:Stomach Ulcer / Q000517:prevention & control; D013312:Stress, Physiological / Q000150:complications
D000900:Anti-Bacterial Agents; D006635:Histamine H2 Antagonists; D011899:Ranitidine