Efficacy of twice-daily cimetidine in pediatric peptic ulcer

The clinical efficacy of twice-daily cimetidine (20 mg/kg/day) was retrospectively studied in 19 children with gastric ulcer (GU) and 23 with duodenal ulcer (DU) in the active stage. Endoscopically confirmed cumulative healing rates at 2, 4, and 8 weeks of treatment were 53.5, 73.7, and 94.7% in the GU group and 15.4, 50.0, and 87.0% in the DU group, respectively. There was no significant difference between the groups at each time point. The mean period of time until complete disappearance of symptoms in the GU and DU groups was 3.5 +/- 2.6 and 4.2 +/- 3.3 days, respectively (NS). With regard to symptoms, abdominal tenderness rather than spontaneous pain appeared to be a better indicator of ulcer healing. Ulcer recurrence was found endoscopically during follow-up in 2 of 13 GU patients (15.4%) and 11 of 19 DU patients (57.9%); thus, the cumulative recurrence rate of the DU group was higher than that of the GU group (p < 0.05). No adverse effects related to cimetidine were demonstrated during treatment or short-term follow-up. We conclude that twice-daily cimetidine at a dosage of 20 mg/kg/day is as effective for the symptomatic improvement and healing of peptic ulcer as the conventional three- or four-times-daily regimens. The optimal dosage of cimetidine requires further study.