scholarly journals Histamine-2 receptor antagonists versus proton pump inhibitors for stress ulcer prophylaxis in the ICU

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 1291
Author(s):  
Petros Kopterides ◽  
Jeremy Kahn
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Gastrointestinal Tract ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Stress Ulcer ◽  
Infectious Complications ◽  
Stress Ulcer Prophylaxis ◽  
Receptor Antagonists ◽  
Ulcer Prophylaxis

An evaluation of a recent study by MacLaren R, Reynolds PM, Allen RR et al: Histamine-2 receptor antagonists vs proton pump inhibitors on gastrointestinal tract hemorrhage and infectious complications in the intensive care unit. JAMA Intern Med 2014, 174:564-574.

scholarly journals Comparison of proton pump inhibitors and histamine 2 receptor antagonists for stress ulcer prophylaxis in the intensive care unit

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Myung Jin Song ◽  
Seok Kim ◽  
Dachung Boo ◽  
Changhyun Park ◽  
Sooyoung Yoo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Adverse Events ◽  
Gastrointestinal Bleeding ◽  
Critically Ill ◽  
Proton Pump ◽  
Critically Ill Patients ◽  
Stress Ulcer ◽  
Stress Ulcer Prophylaxis ◽  
Ulcer Prophylaxis

AbstractProton pump inhibitors (PPIs), followed by histamine 2 receptor antagonists (H2RAs), are the most commonly used drugs to prevent gastrointestinal bleeding in critically ill patients through stress ulcer prophylaxis. The relative efficacy and drug-related adverse events of PPIs and H2RAs remain unclear. In this retrospective, observational, comparative cohort study, PPIs and H2RAs for stress ulcer prophylaxis in critically ill patients were compared using a common data model. After propensity matching, 935 patients from each treatment group (PPI or H2RA) were selected. The PPI group had a significantly higher 90-day mortality than the H2RA group (relative risk: 1.28; P = 0.01). However, no significant inter-group differences in the risk of clinically important gastrointestinal bleeding were observed. Moreover, there were no significant differences between the groups concerning the risk of pneumonia or Clostridioides difficile infection, which are known potential adverse events related to these drugs. Subgroup analysis of patients with high disease severity were consistent with those of the total propensity score-matched population. These findings do not support the current recommendations, which prefer PPIs for gastrointestinal bleeding prophylaxis in the intensive care unit.

scholarly journals INAPPROPRIATE USAGE OF INTRAVENOUS PROTON PUMP INHIBITORS AND ASSOCIATED FACTORS IN A HIGH COMPLEXITY HOSPITAL IN BRAZIL

2021 ◽  
Vol 58 (1) ◽  
pp. 32-38
Author(s):  
Laura M BISCHOFF ◽  
Laura S M FARACO ◽  
Lucas V MACHADO ◽  
Alex V S BIALECKI ◽  
Gabriel M de ALMEIDA ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Stress Ulcer ◽  
High Complexity ◽  
Inappropriate Use ◽  
Ulcer Prophylaxis ◽  
To Receive

ABSTRACT BACKGROUND: Intravenous (IV) use of proton pump inhibitors (PPIs) is advised only in cases of suspected upper gastrointestinal bleeding (UGIB) or impossibility of receiving oral medication, although there has been a persistent practice of their inappropriate use in health institutions. OBJECTIVE: The purpose of our study was to measure the inappropriate use of IV PPIs in a high complexity hospital in Brazil and to estimate its costs. METHODS: Retrospective study of 333 patients who received IV omeprazole between July and December of 2018 in a high complexity hospital in Brazil. RESULTS: IV omeprazole was found to be appropriately prescribed in only 23.4% patient reports. This medication was administered mainly in cases of suspected UGIB (19.1%) and stress ulcer prophylaxis in patients with high risk of UGIB unable to receive medication orally (18.7%). It was observed a statistically significant association between adequate prescription and stress ulcer prophylaxis in patients with high risk of UGIB unable to receive medication orally; patient nil per os with valid indication for PPIs usage; prescription by intensive care unit doctors; prescription by emergency room doctors; intensive care unit admission; evolution to death; sepsis; and traumatic brain injury (P<0.05). On the other hand, inadequate prescription had a statistically significant association with surgical ward prescription and non-evolution to death (P<0.05). The estimated cost of the vials prescribed inadequately was US$1696. CONCLUSION: There was a high number of inappropriate IV omeprazole prescriptions in the studied hospital, entailing greater costs to the institution and unnecessary risks.

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