Comparing the Ventilator-associated Pneumonia Incidence when Pantoprazole or Ranitidine is Used for Stress Ulcer Prophylaxis in Critically Ill Adult Patients

Document Type : Original Article


1 Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences,

2 Trauma Research Center, Shiraz University of Medical Sciences,

3 Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran


Prophylaxis against stress ulcer in mechanically ventilated patients is one of the causes for ventilator-associated pneumonia (VAP). Our aim was evaluating the effect of intravenous pantoprazole and ranitidine in the incidence of VAP in critically ill patients.
Materials and Methods: 
Patients with at least 48 h of expected mechanical ventilation were allocated randomly to receive either 50 mg ranitidine (R) every 8 h or 40 mg pantoprazole (P) every 12 h intravenously from admission. VAP diagnosis was according to the Clinical Pneumonia Infection Score and positive culture.
Eighty-six patients during a 15-month period were analyzed; the study showed a low difference between VAP incidence in the ranitidine and pantoprazole groups. No significant difference was observed in terms of gastrointestinal bleeding, intensive care unit, hospital length of stay, and mortality between the groups.
VAP incidence is hardly related to the type of stress ulcer prophylaxis agent with a high rate of VAP and low utilization of VAP prophylaxis bundle.