Background Stress ulcer prophylaxis (SUP) using ranitidine, a histamine H2 receptor
antagonist, has been associated with an increased risk of ventilator-associated pneumonia.
The proton pump inhibitor (PPI) pantoprazole is also commonly used for SUP. PPI use has
been linked to an increased risk of community-acquired pneumonia. The objective of this
study was to determine whether SUP with pantoprazole increases pneumonia risk
compared with ranitidine in critically ill patients. Methods The cardiothoracic surgery …

There is a direct relationship between stress ulcer prophylaxis and an increased risk of
nosocomial pneumonia in critically ill patients. Source: Miano TA, Reichert MG, Houle TT, et
al. Nosocomial pneumonia risk and stress ulcer prophylaxis: a comparison of pantoprazole
vs. ranitidine in cardiothoracic surgery patients. Chest. 2009; 136: 440–447.