title: Efficacy of and potential morbidities associated with the use of antacid medications in preterm neonates.
abstract: OBJECTIVE
  Antacid medications are frequently administered to preterm infants. These medications can change gastric pH levels and can affect regular gastrointestinal function and gut micro-bacterial flora. We hypothesized that preterm infants exposed to antacid medications are at a greater risk of necrotizing enterocolitis (NEC) and sepsis, and set out to determine any association, as well as to assess the clinical efficacy of these medications.
  
  
  METHODS
  Retrospective chart review of preterm infants ≤30 weeks' gestational age or birth weight ≤1250 g over a 2-year period at New York University Langone Medical Center. Subjects were divided into two groups: those who had been treated with antacid medications and those who had not. We then examined for any difference in NEC (≥Bell stage 2) or culture proven sepsis.
  
  
  RESULTS
  The study comprised 65 eligible neonates, 28 in antacid treatment group and 37 in control. The incidence of NEC (21.4% vs. 2.7%, P=0.04) was significantly higher in the antacid group, but these infants tended to be born more prematurely than control subjects. There was a trend toward more culture proven sepsis cases in the antacid group. We found no difference in signs generally associated with neonatal reflux (apnea, bradycardia, and desaturation events) in subjects treated with antacid medications after treatment began.
  
  
  CONCLUSIONS
  Treatment of preterm infants with antacid medications is potentially associated with a higher risk of NEC, and possibly sepsis, while appearing to provide little benefit.
authors.affiliation: .
authors.forename: Uday P
authors.initials: UP
authors.lastname: Patil
authors.affiliation: .
authors.forename: Sean M
authors.initials: SM
authors.lastname: Bailey
authors.affiliation: .
authors.forename: Elena V
authors.initials: EV
authors.lastname: Wachtel
authors.affiliation: .
authors.forename: Evan
authors.initials: E
authors.lastname: Orosz
authors.affiliation: .
authors.forename: Rebecca
authors.initials: R
authors.lastname: Zarchin
authors.affiliation: .
authors.forename: Pradeep V
authors.initials: PV
authors.lastname: Mally
mesh_terms: D000863:Antacids / Q000009:adverse effects*; D020345:Enterocolitis, Necrotizing / Q000139:chemically induced*; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D012189:Retrospective Studies
chemical_list: D000863:Antacids
keywords: Antacid medication; gastroesophageal reflux; histamine-2 antagonist; necrotizing enterocolitis; neonatal sepsis; proton pump inhibitors