PMID- 25423448
OWN - NLM
STAT- MEDLINE
DCOM- 20150914
LR  - 20220311
IS  - 1744-764X (Electronic)
IS  - 1474-0338 (Linking)
VI  - 14
IP  - 2
DP  - 2015 Feb
TI  - Proton pump inhibitors and histamine-2 receptor antagonists in the intensive care 
      setting: focus on therapeutic and adverse events.
PG  - 269-80
LID - 10.1517/14740338.2015.986456 [doi]
AB  - INTRODUCTION: Histamine-2 receptor antagonists (H2RA) and proton pump inhibitors 
      (PPI) are frequently used to prevent stress-related mucosal bleeding (SRMB). A 
      paucity of data implicates these agents with pneumonia and Clostridium difficile 
      infection (CDI). AREAS COVERED: This review comparatively evaluates the 
      effectiveness of H2RAs and PPIs and delineates their associations with these 
      infectious complications. A literature review through 30 September 2014 was 
      performed. EXPERT OPINION: The rate of SRMB is declining, likely due better 
      resuscitation strategies and the early provision of enteral nutrition. Therefore, 
      gastric acid-suppressing therapies arguably reduce SRMB. However, they may 
      contribute to pneumonia and CDI. The risks of these infectious complications 
      depend on the extent of acid suppression and may vary by patient population. PPIs 
      are associated with the greatest hazard for these infections, likely because they 
      provide stronger acid suppression. Intermittent administration of H2RAs has 
      theoretical advantages over continuous H2RA or PPI therapies as this dosing 
      strategy does not fully suppress gastric acid and may limit infection risk. 
      Placebo-controlled studies are warranted because clinical equipoise exists as the 
      detrimental outcomes of these infections may outweigh the benefit of preventing 
      SRMB given the infrequent occurrence of SRMB.
FAU - MacLaren, Robert
AU  - MacLaren R
AD  - University of Colorado, Skaggs School of Pharmacy and Pharmaceutical Sciences, 
      Department of Clinical Pharmacy , C238, 12850 East Montview Blvd, Aurora, CO 
      80045 , USA +1 303 724 2622 ; +1 303 724 0979 ; Rob.MacLaren@ucdenver.edu.
FAU - Kassel, Lynn E
AU  - Kassel LE
FAU - Kiser, Tyree H
AU  - Kiser TH
FAU - Fish, Douglas N
AU  - Fish DN
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20141125
PL  - England
TA  - Expert Opin Drug Saf
JT  - Expert opinion on drug safety
JID - 101163027
RN  - 0 (Histamine H2 Antagonists)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Clostridioides difficile/drug effects
MH  - Community-Acquired Infections/*chemically induced
MH  - Critical Care
MH  - Enterocolitis, Pseudomembranous/*chemically induced
MH  - Histamine H2 Antagonists/*adverse effects/therapeutic use
MH  - Humans
MH  - Peptic Ulcer Hemorrhage/drug therapy
MH  - Pneumonia/*chemically induced
MH  - Proton Pump Inhibitors/*adverse effects/therapeutic use
OTO - NOTNLM
OT  - Clostridium difficile
OT  - critical care
OT  - gastric acid
OT  - histamine receptor antagonist
OT  - intensive care
OT  - pneumonia
OT  - proton pump inhibitor
OT  - stress ulcer
EDAT- 2014/11/26 06:00
MHDA- 2015/09/15 06:00
CRDT- 2014/11/26 06:00
PHST- 2014/11/26 06:00 [entrez]
PHST- 2014/11/26 06:00 [pubmed]
PHST- 2015/09/15 06:00 [medline]
AID - 10.1517/14740338.2015.986456 [doi]
PST - ppublish
SO  - Expert Opin Drug Saf. 2015 Feb;14(2):269-80. doi: 10.1517/14740338.2015.986456. 
      Epub 2014 Nov 25.