Table 7.
Meta-analysis E: rates of nosocomial pneumonia in patients treated with ranitidine or sucralfate (eight randomised studies)
| Reference | Pneumonia rate
|
Odds ratio (95% CI) | Definition of pneumonia | |
|---|---|---|---|---|
| Ranitidine | Sucralfate | |||
| Pickworth et al, 199319 | 5/44 | 6/39 | 0.72 (0.21 to 2.40) | Presence of new infiltrate in chest x ray picture and three of: rectal temperature >38.5°C, white blood cell count >10 000 cells/mm3, positive sputum culture obtained by leukans trap, or sputum sample obtained by leukans trap with Gram stain containing many white blood cells (>25 white blood cells, <10 epithelial cells, and numerous bacteria/high power field) |
| Eddleston et al, 199120 | 10/30 | 3/30 | 4.02 (1.18 to 17.1) | New and progressive infiltrate in chest x ray picture, unexplained reduction in PaO2, postive culture from tracheal aspirate plus either pyrexia (>38°C) or increase in leucocyte count of >3000/mm3 |
| Thomason et al, 196625 | 27/80 | 30/80 | 0.85 (0.45 to 1.61) | According to Garner et al27: infiltrate in chest x ray picture plus three of: leucocytosis >10 000 cells/mm3; Gram negative organisms on tracheal or blood culture; tracheal Gram stain showing moderate to heavy bacteria or polymorphoneutrophils (>25/high power field); pathogens isolated from tracheal culture; temperature >38°C |
| Prod'hom et al, 199421 | 21/80 | 10/83 | 2.53 (1.15 to 5.86) | According to Salata et al28: new or progressive infiltrate in chest x ray picture and at least one of: microbiological or histopathological evidence of pneumonia; presence of at least two of: leucocytes on Gram stain, new leucocytosis, temperature increase from <37.5°C to >38.5°C |
| O'Keefe et al, 199826 | 14/49 | 10/47 | 1.46 (0.59 to 3.70) | Leucocytes >12 000/ mm3, new or changing infiltrate in chest x ray picture, temperature >38.5°C or <36.5°C, and positive sputum and Gram stain for specific pathogens. Results of this clinical trial have in part been reported in separate publication (Maier et al, 199424) |
| Laggner et al, 198922 | 2/16 | 0/16 | 5.67 (not computable) | New infilitrate in chest x ray picture with bronchial colonisation, leucocytosis (>15 000/mm3), and fever >38.5°C |
| Cook et al, 19983 | 114/596 | 98/604 | 1.22 (0.91 to 1.64) | By consensus of specific pneumonia adjudication committee. Main criteria included new infiltrate in chest x ray picture plus at least two of: temperature >38.5°C or <35.0°C; leucocyte count >10 000 cells/mm3 or <3000 cells/mm3; purulent sputum or positive culture |
| Mustafa et al, 199523 | 9/16 | 3/15 | 4.52 (1.12 to 23.6) | No specific definition |
| Total | 202/911 (22%) | 160/914 (18%) | — | |