A Randomized Clinical Trial Comparing the Efficacy of Ranitidine and Famotidine on Intragastric Acidity in Critically Ill Pediatric Patients
PRAPUN AANPREUNG, M.D.*, CHAKRAPHAN SUS IV A, M.D.*, NIRUN VANPRAPAR, M.D.*, CHINTANA PARKPREAW, B.N.*, CHOMPOONOOH BOONYACHART, B.N.*
Affiliation : * Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Abstract We examined the efficacy of intravenous ranitidine and famotidine on raising intra- gastric pH in each of 10 critically ill pediatric patients. The severity of illness was assessed by using the modified zinner index score. The study had 3 phases and each phase took 24 hours. Intragastric pH was measured by continuous pH monitoring digitrapper for 72 hours. In phase I and 3, the patients did not receive any H2 blockers. In phase 2, they were randomized to receive intravenous ranitidine or famotidine. The majority of cases had intragastric pH < 4 in day I (base line). Ranitidine and famotidine increased total time of intragastric pH ~ 4 from the base line during day 2, 38.2 ± 16.9 per cent and 60.3 ± 24.8 per cent respectively (P0.004), but there was no statistical difference between the 2 medications in both Zinner index score I and score greater than I group (P 0.08, 0.45). Three cases in the famotidine group had successful prophylaxis with total time pH ~ 4 more than 80 per cent. Famotidine appeared to have a trend toward in- creasing intragastrie pH in critically ill pediatric patients.
Keywords :
