Reasons for performing study: The use of anti-ulcer medication in the neonatal intensive care unit (ICU) is common due to the concern for development of
catastrophic gastric ulcer disease. In man, however, the use of acid-suppressive medication has been shownin some studies to be a substantial risk factor for
the development of Clostridium difficile-associated diarrhoea (CDAD), bacteraemia and neonatal sepsis.
Objective: The purpose of the study reported herein is to evaluate the influence of anti-ulcer medications on the development of diarrhoea in the
neonatal foal.
Hypothesis: The use of anti-ulcer medication does not alter the incidence of diarrhoea in foals treated in an ICU.
Methods: The records of 1710 foals from 6 different equine hospitals were examined and the use of anti-ulcer drugs was recorded. The presence of
in-hospital acquired diarrhoea, CDAD, Clostridium perfringens-associated diarrhoea, neonatal sepsis and salmonellosis were documented. In addition, the
presence of gastric ulceration, duration of hospital stay and short-termoutcome were examined.
Results: The use of anti-ulcer medications increased the odds of in-hospital diarrhoea by 2.0 (95% CI 1.4–2.9; P<0.0001), relative to the use of no anti-ulcer
medication. There was no significant association of anti-ulcer medication with CDAD (P = 0.3189) (OR 2.0; 95% CI 0.4–9.5). Further, results indicated that
decreased prevalence of gastric ulceration was not associated with use of anti-ulcer drugs among foals in the study for which these data were known
(P = 0.5522).
Conclusions: Use of anti-ulcer drugs increases the odds of developing diarrhoea, and may not reduce the incidence of gastric ulceration in hospitalised
equine neonates.
Potential relevance: The use of anti-ulcer drugs in neonatal foals being treated in a hospital setting should be carefully evaluated on an individual basis to
determine if such use is warranted.