Safety of histamine-2 receptor blockers in hospitalized VLBW infants.

Journal Article (Journal Article;Multicenter Study)

BACKGROUND: Histamine-2 receptor (H2) blockers are often used in very low birth weight infants despite lack of population specific efficacy and safety data. AIMS: We sought to describe safety and temporal trends in histamine-2 receptor (H2) blocker use in hospitalized very low birth weight (VLBW) infants. STUDY DESIGN: We conducted a retrospective cohort study using a clinical database populated by an electronic health record shared by 348 neonatal intensive care units in the United States. SUBJECTS: We included all VLBW infants without major congenital anomalies. OUTCOME MEASURES: We used multivariable logistic regression with generalizing estimating equations to evaluate the association between days of H2 blocker exposure and risk of: 1) death or necrotizing enterocolitis (NEC); 2) death or sepsis; and 3) death, NEC, or sepsis. RESULTS: Of 127,707 infants, 20,288 (16%) were exposed to H2 blockers for a total of 6,422,352days. Median gestational age for infants exposed to H2 blockers was 27weeks (25th 75th percentile 26, 29). H2 blocker use decreased from 18% of infants in 1997 to 8% in 2012 (p<0.001). On multivariable analysis, infants were at increased risk of the combined outcome of death, NEC, or sepsis on days exposed to H2 blockers (odds ratio=1.14) (95% confidence interval 1.08, 1.19). CONCLUSIONS: H2 blocker use is associated with increased risk of the combined outcome of death, NEC, or sepsis in hospitalized VLBW infants.

Full Text

Duke Authors

Cited Authors

  • Romaine, A; Ye, D; Ao, Z; Fang, F; Johnson, O; Blake, T; Benjamin, DK; Cotten, CM; Testoni, D; Clark, RH; Chu, VH; Smith, PB; Hornik, CP; Best Pharmaceuticals for Children Act – Pediatric Trials Network,

Published Date

  • August 2016

Published In

Volume / Issue

  • 99 /

Start / End Page

  • 27 - 30

PubMed ID

  • 27390109

Pubmed Central ID

  • PMC4969147

Electronic International Standard Serial Number (EISSN)

  • 1872-6232

Digital Object Identifier (DOI)

  • 10.1016/j.earlhumdev.2016.05.010


  • eng

Conference Location

  • Ireland