THE ROLE OF H-2-RECEPTOR ANTAGONISTS IN THE PATHOGENESIS OF NOSOCOMIAL PNEUMONIA IN MECHANICALLY VENTILATED PATIENTS

We conducted a computerized MEDLINE search and selected controlled stu dies and meta-analyses correlating the frequency of nosocomial pneumon ia (NP) with the administration of histamine(2)-receptor antagonists ( H2RAs) as stress ulcer prophylaxis in critically ill patients. Althoug h such a correlation does exist, the literature supports the theory th at gastric bacterial overcolonization through alkalinization by H2RAs is not a risk factor for NP in critically ill patients. Further well-d esigned studies are necessary to resolve the issue and clarify the rol e of H2RAs in the pathogenesis of NP.