title: Treatment with histamine-type 2 receptor antagonists and omeprazole increase the risk of diarrhoea in neonatal foals treated in intensive care units.
abstract: BACKGROUND
  The use of anti-ulcer medication in the neonatal intensive care unit (ICU) is common due to the concern for development of catastrophic gastric ulcerdisease. In man, however, the use of acid-suppressive medication has been shown in some studies to be a substantial riskfactorfor the development of Clostridium difficile-associated diarrhoea (CDAD), bacteraemia and neonatal sepsis.
  
  
  OBJECTIVE
  The purpose of the study reported herein is to evaluate the influence of anti-ulcer medications on the development of diarrhoea in the neonatalfoal.
  
  
  OBJECTIVE
  The use of anti-ulcer medication does not alter the incidence of diarrhoea in foals treated in an ICU.
  
  
  METHODS
  The records of 1710 foals from 6 different equine hospitals were examined and the use of anti-ulcer drugs was recorded. The presence of in-hospital acquired diarrhoea, CDAD, Clostridium perfringens-associated diarrhoea, neonatal sepsis and salmonellosis were documented. In addition, the presence of gastric ulceration, duration of hospital stay and short-term outcome were examined.
  
  
  RESULTS
  The use of anti-ulcer medications increased the odds of in-hospital diarrhoea by 2.0 (95% CI 1.4-2.9; P < 0.0001), relative to the use of no anti-ulcer medication. There was no significant association of anti-ulcer medication with CDAD (P = 0.3189) (OR 2.0; 95% CI 0.4-9.5). Further, results indicated that decreased prevalence of gastric ulceration was not associated with use of anti-ulcer drugs among foals in the study for which these data were known (P = 0.5522).
  
  
  CONCLUSIONS
  Use of anti-ulcer drugs increases the odds of developing diarrhoea, and may not reduce the incidence of gastric ulceration in hospitalised equine neonates.
  
  
  CONCLUSIONS
  The use of anti-ulcer drugs in neonatal foals being treated in a hospital setting should be carefully evaluated on an individual basis to determine if such use is warranted.
authors.affiliation: Virginia-Maryland Regional College of Veterinary Medicine, Marion DuPont Scott Equine Medical Center, Leesburg, Virginia, USA. mfurr@vt.edu
authors.forename: M
authors.initials: M
authors.lastname: Furr
authors.forename: N D
authors.initials: ND
authors.lastname: Cohen
authors.forename: J E
authors.initials: JE
authors.lastname: Axon
authors.forename: L C
authors.initials: LC
authors.lastname: Sanchez
authors.forename: L
authors.initials: L
authors.lastname: Pantaleon
authors.forename: E
authors.initials: E
authors.lastname: Haggett
authors.forename: R
authors.initials: R
authors.lastname: Campbell
authors.forename: B
authors.initials: B
authors.lastname: Tennent-Brown
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D000897:Anti-Ulcer Agents / Q000009:adverse effects*; D003015:Clostridium Infections / Q000150:complications / Q000662:veterinary; D003967:Diarrhea / Q000139:chemically induced / Q000662:veterinary*; D005260:Female; D006635:Histamine H2 Antagonists / Q000009:adverse effects*; D006734:Horse Diseases / Q000139:chemically induced*; D006736:Horses; D006762:Hospitals, Animal; D007362:Intensive Care Units; D008297:Male; D009853:Omeprazole / Q000009:adverse effects*; D012307:Risk Factors; D012481:Salmonella Infections, Animal / Q000150:complications; D018805:Sepsis / Q000150:complications / Q000662:veterinary
chemical_list: D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists; D009853:Omeprazole