title: Acid reducing agents to neonates - lack of evidence and guidelines.
abstract: OBJECTIVE
  The aim of this retrospective study was to investigate the clinical practice, i.e. the frequency of use and the treatment strategies, for acid reducing drugs to neonates in a Swedish hospital.
  
  
  METHODS
  Retrospective reviews of charts and interviews with nurses at the neonatal wards of Karolinska University Hospital were performed to identify difficulties that might occur with drug administration. All patients admitted over a 2-month period were included. Main outcome measure were the number of patients treated with acid reducing drugs and the dosages.
  
  
  RESULTS
  Nine out of 215 patients (4.2%) received an acid reducing drug. Patients treated with acid reducing drugs had significantly lower birth weight, lower gestational age and longer duration of hospitalization. Eight of the patients were treated with omeprazole. One of these patients started treatment with omeprazole but continued later on with ranitidine. One patient was exclusively treated with ranitidine. The doses of omeprazole (intravenous or oral administration) were within the range 0.16-1.26 mg/kg/day.
  
  
  CONCLUSIONS
  A wide variation in treatment regimens of acid reducing drugs is given to newborn infants. The percentage of treated children was much lower than earlier reports from the US and UK. No conclusions can be drawn as to whether the doses and dosing intervals used give sufficient acid suppression, since the effect of the therapy was not recorded. The present study is only retrospective and data are not truly comparable with other studies. Further studies are therefore warranted to evaluate effective doses and pharmacokinetics of acid reducing drugs in newborn infants.
authors.affiliation: Karolinska Pharmacy, Karolinska University Hospital, StockholmSweden.
authors.forename: Stina
authors.initials: S
authors.lastname: Paulsson
authors.affiliation: Department of Women's and Children's Health, Karolinska Institutet; Karolinska Pharmacy; and Astrid Lindgren Children's Hospital, Karolinska University Hospital, StockholmSweden.
authors.forename: Staffan
authors.initials: S
authors.lastname: Eksborg
authors.affiliation: Karolinska Pharmacy and Astrid Lindgren Children's Hospital, Karolinska University Hospital, StockholmSweden.
authors.forename: Åsa
authors.initials: Å
authors.lastname: Andersson
authors.affiliation: Karolinska Pharmacy and Astrid Lindgren Children's Hospital, Karolinska University Hospital, StockholmSweden.
authors.forename: Per
authors.initials: P
authors.lastname: Nydert
authors.affiliation: Department of Women's and Children's Health, Karolinska Institutet and Astrid Lindgren Children's Hospital, Karolinska University Hospital, StockholmSweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Grahnquist
keywords: Histamine2 receptor antagonists; Neonates; Pharmaceutical preparations; Proton pump inhibitors