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Comparison of Cimetidine and Placebo for the Prophylaxis of Upper Gastrointestinal Bleeding Due to Stress-related Gastric Mucosal Damage in the Intensive Care Unit

Smith Kline & French Laboratories, Philadelphia, PA

Thomas J. Iberti

Mount Sinai Medical Center, New York

Jeffrey Silverstein

Brookdale Hospital Medical Center, Brooklyn, NY

Leslie Lindenberg

Hartford Hospital, Hartford, CT

Peter Rright-Asare

King-Drew Medical Center, Los Angeles, CA

Frank Rockhold

Smith Kline & French Laboratories, Philadelphia, PA

Michael D. Young

Smith Kline & French Laboratories, Philadelphia, PA

A multicenter, randomized, double-blind, placebo- controlled study was conducted with 87 patients in in tensive care units to study the effectiveness of constant infusions of cimetidine (50 mg/hr) in the prophylaxis of stress-related mucosal bleeding. Fifty-four patients re ceived cimetidine and 33 received placebo. The groups were comparable by age, sex, and severity of illness. One (2%) of the 54 patients receiving cimetidine had upper gastrointestinal hemorrhage and 7 (21%) of the 33 patients receiving placebo had upper gastrointestinal hemorrhage (p = 0.002). The risk of bleeding for every 100 patient days in intensive care units was reduced by 94% in the patients receiving cimetidine. Constant infu sion cimetidine was well tolerated. Only one patient (cimetidine) developed pneumonia during the study, but it was not considered to be related to drug therapy. No patients experienced adverse drug interactions. Two patients (4%) experienced reversible side effects from treatment. Cimetidine, administered as a continuous in travenous 50-mg/hour infusion, is safe and significantly more effective than placebo for preventing upper gas trointestinal bleeding in critically ill patients.

Journal of Intensive Care Medicine, Vol. 5, No. 1, 26-32 (1990)
DOI: 10.1177/088506669000500106


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