Physicians’ Opinions of Stress Ulcer Prophylaxis: Survey Results from a Large Urban Medical Center

Abstract

Despite the publication of guidelines, misuse of gastric acid suppressants continues to occur, even by attending physicians. More complete understanding of the need and occasion for SUP use should result in more cautious use.

We have had a gutful: The need for deprescribing proton pump inhibitors

“…Prescriber and patient factors lead to inappropriate prescribing of PPIs. Prescribers may prescribe a PPI inappropriately because they perceive that PPIs are harmless medicines, perhaps leading to overprescribing and less rigorous follow‐up . Nearly all the adverse outcomes associated with PPIs occur among patients who receive long‐term therapy; minimizing the duration of treatment by periodically reviewing a patient's need for ongoing therapy could eliminate or substantially reduce the risk of adverse outcomes …”

Proton Pump Inhibitors and the Risk for Hospital-Acquired Clostridium difficile Infection

“…[9][10][11][12] Furthermore, PPIs have become the predominant agent of choice despite the lack of randomized studies illustrating superiority over H2RAs. 13,14 As institutions aim to reduce inappropriate medication usage and avoid untoward adverse drug events, the relationship between PPIs and CDI must be further explored. Although intensive acid suppression appears to be associated with CDI, most patients receive a standard daily dose of PPI as part of an SUP regimen.…”

Stress ulcer prophylaxis in the intensive care unit

“…In another survey of 100 physicians (39 attending physicians, 61 residents) regarding SUP, all residents preferred a PPI for SUP compared with 85% of attending physicians ( p < 0.05). However, more attending physicians than residents agreed that using PPIs increased the risk of community‐acquired pneumonia ( p < 0.05) [9].…”