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Association between histamine-2 receptor antagonists and adverse outcomes in neonates: A systematic review and meta-analysis.

ABSTRACT: BACKGROUND:The use of histamine-2 receptor antagonists (H2RA) in neonates is still debated because of possible risk of infection, necrotizing enterocolitis (NEC) and increased mortality. AIM:To review whether the use of H2RA in neonates admitted to neonatal intensive care units (NICU) is associated with infection, NEC or mortality. MATERIALS AND METHOD:We performed a systematic search in PubMed, Web of Science and SCOPUS databases using the terms "histamine-2 receptor antagonists", "infection", "necrotizing enterocolitis", "mortality", "neonates" and related terms to identify studies published up to April 30, 2017. We included studies conducted in hospitalized neonates and exposed to H2RA. The primary outcomes were infection, NEC and mortality. We included reports of infections with clinical signs and positive culture, and NEC according to Bell stages (stage ?II) based on standardised clinical and radiologic criteria. Among 1,144 studies identified, 10 fulfilled the selection criteria. Information extracted included study design, sample size and number of participants, along with the outcomes of interest. We conducted a meta-analysis of adjusted data and pooled estimates of infection, NEC and mortality are reported as odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS:Ten studies were analysed. There were substantial associations between H2RA and infection (pooled OR: 2.09; 95%CI: 1.35-3.24; P = 0.001) and NEC (pooled OR: 2.81, 95%CI: 1.19-6.64; P = 0.02) but not with the mortality risk (pooled OR: 1.76; 95%CI: 0.50-6.16; P: 0.38). CONCLUSION:Current evidence suggests that H2RA is associated with an increased risk of infection and NEC, but not with mortality in neonates admitted to NICU. The use of H2RA in neonates must be stringently considered when necessary.

SUBMITTER: Santos VS

PROVIDER: S-EPMC6448909 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Association between histamine-2 receptor antagonists and adverse outcomes in neonates: A systematic review and meta-analysis.

Santos Victor S VS Freire Marina S MS Santana Ruth N S RNS Martins-Filho Paulo R S PRS Cuevas Luis E LE Gurgel Ricardo Q RQ

PloS one 20190404 4

<h4>Background</h4>The use of histamine-2 receptor antagonists (H2RA) in neonates is still debated because of possible risk of infection, necrotizing enterocolitis (NEC) and increased mortality.<h4>Aim</h4>To review whether the use of H2RA in neonates admitted to neonatal intensive care units (NICU) is associated with infection, NEC or mortality.<h4>Materials and method</h4>We performed a systematic search in PubMed, Web of Science and SCOPUS databases using the terms "histamine-2 receptor antag ...[more]

PMID: 30947259

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Project description:BackgroundAsthma is the most common chronic condition of childhood. Leukotriene receptor antagonists (LTRAs) are included in international guidelines for children and young people (CYP), but there have been highly publicised concerns about potential adverse effects. The aim was to identify and understand the reported frequency of adverse drug reactions (ADRs) attributed to LTRAs in CYP with asthma.MethodsEmbase, MEDLINE, PubMed and CINAHL were searched up to October 2020. Reference lists of eligible papers were manually screened. Eligible studies identified adverse events attributed to an LTRA in individuals aged between 0 and 18 years diagnosed with asthma. Four different tools were used to assess risk of bias or quality of data to accommodate the papers assessed.ResultsThe search identified 427 papers after deduplication; 15 were included (7 case reports, 7 case-controlled or cohort studies and 1 randomised control trial (RCT)). 7012 patients were recorded, of which 6853 received an LTRA. 13 papers examined the ADRs attributed to montelukast, one to pranlukast and one to unspecified LTRAs. After language standardisation, 48 ADRs were found, 20 of which were psychiatric disorders. Across all studies, the most commonly reported ADRs were 'anxiety', 'sleep disorders' and 'mood disorders'. The frequency of ADRs could be calculated in seven of the eight studies. Applying standardised frequency terms to the prospective studies and RCT, there were 14 'common' and 'uncommon' ADRs. 'Common' ADRs included 'agitation/hyperactivity/irritability/nervousness', 'aggression' and 'headache'. The case reports showed a similar pattern, describing 46 different ADRs experienced by a total of eight patients.ConclusionsLTRAs have a wide range of suspected ADRs in CYP, predominantly gastrointestinal and neuropsychiatric disorders. Careful monitoring of CYP with asthma is required, both to assess and manage ADRs and to step treatment down when clinically stable.Prospero registration numberCRD42020209627.

Dataset Information

Association between histamine-2 receptor antagonists and adverse outcomes in neonates: A systematic review and meta-analysis.

Publications

Association between histamine-2 receptor antagonists and adverse outcomes in neonates: A systematic review and meta-analysis.

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