scholarly journals Risk of Clostridium difficile Infection with the Use of a Proton Pump Inhibitor for Stress Ulcer Prophylaxis in Critically Ill Patients

Gut and Liver ◽  
2016 ◽  
Vol 10 (4) ◽  
pp. 581-586 ◽  
Author(s):  
Youngouk Ro ◽  
Chang Soo Eun ◽  
Hyun Soo Kim ◽  
Ji Yeoun Kim ◽  
Young Jae Byun ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Proton Pump Inhibitor ◽  
Critically Ill ◽  
Proton Pump ◽  
Clostridium Difficile Infection ◽  
Critically Ill Patients ◽  
Stress Ulcer ◽  
Stress Ulcer Prophylaxis ◽  
Ulcer Prophylaxis

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.

Proton-Pump Inhibitors for Stress Ulcer Prophylaxis in Critically Ill Patients

2002 ◽  
Vol 36 (12) ◽  
pp. 1929-1937 ◽  
Author(s):  
Rose Jung ◽  
Robert MacLaren
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Critically Ill Patients ◽  
Comparative Studies ◽  
Stress Ulcer ◽  
Stress Ulcer Prophylaxis ◽  
Intragastric Ph ◽  
Ulcer Prophylaxis

OBJECTIVE: To evaluate the use of proton-pump inhibitors (PPIs) for stress ulcer prophylaxis in critically ill adults. DATA SOURCES: Computerized biomedical literature search of MEDLINE (1966–June 2002) was conducted using the MeSH headings proton-pump inhibitor, ulcer, critical care, and acid. References of selected articles were reviewed. A manual search of critical care, surgery, trauma, gastrointestinal, and pharmacy journals was conducted to identify relevant abstracts. DATA SYNTHESIS: Traditional medications used for stress ulcer prophylaxis include antacids, histamine2 receptor antagonists (H2RAs), and sucralfate. Few studies have evaluated PPIs for stress ulcer prophylaxis. The majority of studies have demonstrated that enteral or intravenous administration of PPIs to critically ill patients elevates intragastric pH and consistently maintains pH ≥4.0. PPIs are safe and seem to be as efficacious as H2RAs or sucralfate for prevention of bleeding from stress-related mucosal damage (SRMD) and they may provide cost minimization. The small patient populations limit the results of comparative studies. CONCLUSIONS: Available data indicate that PPIs are safe and efficacious for elevating intragastric pH in critically ill patients. PPIs should be used only as an alternative to H2RAs or sucralfate since the superiority of PPIs over these agents for preventing SRMD-associated gastrointestinal bleeding has not been established. Additional comparative studies with adequate patient numbers and pharmacoeconomic analyses are needed before PPIs are considered the agents of choice for stress ulcer prophylaxis.

Proton Pump Inhibitors Versus Histamine-2-Receptor Antagonists for Stress Ulcer Prophylaxis in Critically Ill Patients

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Smit S. Deliwala ◽  
Kewan Hamid ◽  
Hemant Goyal ◽  
Anoosha Ponnapalli ◽  
Yazan Zayed ◽  
...  
Keyword(s):  
Critically Ill ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Critically Ill Patients ◽  
Stress Ulcer ◽  
Stress Ulcer Prophylaxis ◽  
Receptor Antagonists ◽  
Ulcer Prophylaxis
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