Evid Based Med 18:36-37 doi:10.1136/ebmed-2012-100622
  • Aetiology
  • Cohort study

Ranitidine use is associated with increased morbidity and mortality in very low birthweight infants

  1. William F Malcolm
  1. Department of Pediatrics-Neonatology, Duke University, Durham, North Carolina, USA
  1. Correspondence to: C Michael Cotten
    Pediatrics-Neonatology, Duke University, 2424 Erwin Road suite 504, Durham, NC 27705, USA; cotte010{at}

Commentary on:


Gastroesophageal reflux (GER) is the retrograde movement of stomach contents into the oesophagus. Pharmacotherapy aimed at reducing problems attributed to GER includes histamine receptor blockers (H2 blockers), such as ranitidine, which reduce stomach acidity. Extremely preterm infants often exhibit clinical signs consistent with GER,1 and GER medications are among the most commonly prescribed medications in neonatal intensive care units (NICUs).2

Approximately one third of extremely premature (<28 weeks gestation), very low birthweight (VLBW; <1500 g) infants acquire infections during their NICU stay. Necrotising enterocolitis (NEC), a serious intestinal morbidity in preterm infants, occurs in approximately 10%. About half …

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