Abstract
The dose of cimetidine necessary to suppress gastric acid production in pediatric patients is not well established. Consequently, we studied 9 pts (mean age 7 yr, range 8m-10yr) with GI and/or pulmonary symptoms of gastroesophageal reflux, documented by abnormal overnight esophageal pH probe. The probe was then advanced into the stomach and gastric pH recorded before and after oral doses of cimetidine: 4 pts received randomized doses (5,7.5,and 10 mg/kg) at 8-hr intervals; 5 pts received 5 and 10 mg/kg at 4-hr intervals. Age-appropriate standardized meals were given starting 1 hr following administration of the initial dose. Efficacy of gastric acid suppression was defined as gastric pH >4.RESULTS:*One pt, unresponsive to all 3 doses, was treated with 14.3 mg/kg; gastric pH measured >4 for 1.4 hrs only.CONCLUSIONS: 1) Currently used cimetidine doses of 5 and 7.5 mg/kg fail to suppress gastric acid for >1 hr in some pts. 2) Two pts were unresponsive to doses as high as 10 mg/kg. 3) Documentation of gastric acid suppression is indicated in the management of pediatric patients with peptic related disease.
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