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Question 1: Does the use of ranitidine increase the risk of NEC in preterm infants?
  1. Manigandan Chandrasekaran,
  2. Paul Fleming
  1. Neonatal Unit, Homerton University Hospital NHS Trust, London, UK
  1. Correspondence to Dr Manigandan Chandrasekaran, Neonatal Unit, Homerton University Hospital NHS Trust, Homerton Row, Homerton, London E9 6SR, UK; mani{at}pediatrician.com

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Clinical scenario

You are the neonatal registrar doing a ward round with your consultant. A preterm 4-week-old infant, who was born at 26 weeks gestation, is on continuous nasal continuous positive airway pressure (NCPAP). This baby is enterally fed with expressed breast milk, and being treated with ranitidine for presumed gastro-esophageal reflux disease.

The consultant questioned the risk of necrotising enterocolitis (NEC) with the use of ranitidine.

Structured clinical question

In preterm infants (patient), does the use of ranitidine (intervention) increase the risk of NEC (outcome)?

Search strategy and outcome

The keywords ‘Premature infant’ ‘NEC’ and ‘Ranitidine’ were used.

Secondary sources: Cochrane: no relevant results.

Primary sources: Pubmed (1980–2013), Embase (1980–2013) and CINAHL (1982–2013) databases were searched. There were 101 articles in Pubmed, 56 articles in Embase and 174 articles in CINAHL. Seven relevant articles were identified. Four articles were excluded (two were commentaries, one was a review article and one studied …

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