Intravenous proton pump inhibitor use in hospital practice.
OBJECTIVE
North American studies suggest that intravenous proton pump inhibitors are used inappropriately in hospital practice, but little is known of prescribing patterns in Europe. Our aim was to examine intravenous proton pump inhibitors prescribing in a single university teaching hospital.


METHODS
Observational study of 101 consecutive hospital patients administered intravenous proton pump inhibitors over a 3-month period in a single hospital in Dublin, Ireland. Demographic, clinical, biochemical, haematological, endoscopic and follow-up data were collected and analysed.


RESULTS
Sixty-five percent (65 of 101) of the patients had no objective evidence of gastrointestinal blood loss and 85 were haemodynamically stable before treatment. Two patients underwent endoscopic haemostasis before IV administration. The remaining 99 were treated for ulcer prophylaxis, presumed gastrointestinal haemorrhage, unrelated gastrointestinal conditions or for unknown reasons. Relatively senior nonconsultant staff prescribed intravenous therapy in most cases. Only six patients in the study were deemed to have received intravenous therapy for an appropriate indication.


CONCLUSIONS
Intravenous proton pump inhibitors use in hospital practice is usually inappropriate. It may be that other valid indications exist within hospital practice, but these might reasonably be evaluated in randomized trials that would assess the risks and costs of intravenous treatments as well as their benefits.
Slattery
Eoin
E
Department of Gastroenterology, St Vincent's University Hospital, Dublin, Ireland.
Theyventhiran
Ruben
R
Cullen
Garret
G
Kennedy
Fionnula
F
Ridge
Carol
C
Nolan
Karen
K
Kidney
Rachel
R
O'Donoghue
Diarmuid P
DP
Mulcahy
Hugh E
HE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005260:Female; D005767:Gastrointestinal Diseases / Q000188:drug therapy; D006785:Hospitals, University; D006801:Humans; D007262:Infusions, Intravenous; D007494:Ireland; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors
D054328:Proton Pump Inhibitors