Acid-Suppressive Therapy for Stress Ulcer Prophylaxis in a Teaching Hospital Intensive Care Unit

초록

Research findings, showing inappropriate use of acid-suppressive therapy (AST) for stress ulcer prophylaxis (SUP) in patients without risk factors for stress ulcer, have been reported recently. The aim of this study was to evaluate whether AST was appropriately used for intensive care unit (ICU) patients who had qualifying risk factors for SUP according to the American Society of Health System Pharmacists (ASHP) therapeutic guidelines on SUP. In addition, this study aimed to investigate the prescription patterns of AST for SUP. Patients who received AST for SUP at least once or more in the ICU in a teaching hospital from January to April, 2012 were included in this study. We reviewed whether each patient had any qualifying risk factors for SUP according to the ASHP therapeutic guidelines. Then we statistically analyzed the baseline characteristics and prescription patterns of AST of the patients. Of 250 patients who received AST for SUP in the ICU, 114 (45.6%) were non-candidates (patients having no qualifying risk factors for SUP) according to the ASHP guidelines. Eighty-four patients (33.6%) had "head injury with Glasgow Coma Score of <= 10 or inability to obey simple commands" as qualifying risk factors for SUP. Histamine 2 receptor antagonist (H2RA) was the most commonly used AST for SUP (99.6%), and therapeutic duplication of AST was observed in 20 patients (8.0%). This study found that almost half of the patients who received AST for SUP at least once or more in the ICU had no qualifying risk factors for SUP based on the ASHP guidelines, and the majority of patients received H2RA as AST for SUP.

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