95 Acid-suppressing medications and sepsis in surgical neonates: Is there an association?
DIna Fouad, Hemanshoo Thakkar, Manasvi Upadhyaya
Evelina London Children's Hospital, London, United Kingdom

Abstract

Introduction

Acid-suppressing medications such as H2 antagonists and proton pump inhibitors (PPIs) have been shown to increase the risk of sepsis in the neonatal population.

Methods

Retrospective analysis of prospectively collected data over 6 years (January 2010 - December 2015) was completed. All neonatal admissions were included and then divided into “surgical” and “non-surgical” patients “with sepsis” and “without sepsis”. Sepsis was defined as a positive blood culture and clinical suspicion of sepsis. Data included gestational age (GA), birthweight (BW), presence of central venous line (CVL) and receipt of a PPI and/or H2 antagonists.

Results

n=3261 patients (1527 surgical, 1734 non-surgical). Incidence of sepsis was 22% (n=717). Surgical patients with sepsis remained more likely to have a CVL (OR 1.51, 95% CI 1.16-1.97, p<0.01) and PPI (OR 1.95, 95% CI 1.24-3.08, p<0.01). Surgical patients with sepsis were significantly more likely to have a CVL, PPI (12% vs 0%, p=0.002) or H2 antagonist (17% vs 6%, p=0.03) when compared to non-surgical patients with sepsis. Non-surgical patients with sepsis were more likely to be of a lower GA (OR 0.99, 95% CI 0.98-0.99, p<0.001) and have a CVL (OR 1.21, 95% CI 1.17-1.24, p<0.001) but not to have received acid-suppressing medication.

Conclusion

  • Surgical neonates with sepsis were significantly more likely to be of lower GA, BW, have a CVL, have received PPI when compared to surgical patients without sepsis and PPI or H2 antagonists when compared to non-surgical patients with sepsis.


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