Stress ulcer prophylaxis in trauma patients.
BACKGROUND
A number of issues concerning stress ulcer prophylaxis remain unresolved despite numerous randomized, controlled trials and several meta-analyses. The role of stress ulcer prophylaxis, particularly in trauma patients, is further complicated by the lack of trials utilizing clinically important bleeding as an endpoint. Given the lack of consensus regarding stress ulcer prophylaxis in trauma patients, prescribing practices at Level I trauma centers in the United States were assessed.


METHODS
A survey was developed that contained questions related to institutional prescribing and evaluation of stress ulcer prophylaxis. The survey was intended to delineate these practices at the 188 Level I trauma centers (at the time of the present survey) in the United States.


RESULTS
One hundred and nineteen surveys were returned, yielding a response rate of 63%. Eighty-six percent stated that medications for stress ulcer prophylaxis are used in a vast majority of trauma patients admitted to the intensive care unit. Sixty-five percent stated that there is one preferred medication. For these institutions, histamine-2-blockers were the most popular at 71%. Thirty-nine percent stated that greater than 50% of patients remain on stress ulcer prophylaxis following discharge from the intensive care unit.


CONCLUSIONS
The lack of consensus with regards to appropriate stress ulcer prophylaxis is apparent in this survey of Level I trauma centers. For those institutions with a preferred agent, histamine-2-blockers were most common.
Barletta
Jeffrey F
JF
Department of Pharmacy Practice, Detroit Receiving Hospital, Michigan, USA. jbarlett@dmc.org
Erstad
Brian L
BL
Fortune
John B
JB
D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D004363:Drug Utilization; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D010437:Peptic Ulcer / Q000209:etiology / Q000517:prevention & control*; D010818:Practice Patterns, Physicians'; D011292:Premedication; D013312:Stress, Physiological / Q000150:complications* / Q000209:etiology; D014481:United States; D014947:Wounds and Injuries / Q000150:complications / Q000628:therapy*
D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists