Clinical Outcomes of Acid Suppressive Therapy Use in Hematology/Oncology Patients at an Academic Medical Center.
Acid suppressive therapy (AST)-namely, proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs)-is routinely prescribed to hospitalized patients for stress ulcer prophylaxis (SUP).



To identify the incidence of and indications for AST use in the hematology/oncology population as well as to identify the occurrence of the following PPI-associated adverse events: pneumonia and Clostridium difficile-associated diarrhea (CDAD).



A retrospective chart review was conducted on adult hematology/oncology patients admitted to any oncology service for ≥48 hours from October 1, 2014, to December 31, 2014.



Of the 298 patients who met the inclusion criteria, 73% (n = 218) received an AST during admission. The most common indication for an AST was SUP (63%). The incidence of hospital-acquired pneumonia (HAP) was 10%, 0%, and 4% in patients who received a PPI, H2RA, and no AST, respectively (14/142 vs 0/70 vs 3/80; odds ratio [OR] for PPI vs no AST = 2.68; 95% CI = 0.75-9.63). The incidence of CDAD was 3%, 1.3%, and 1.2% in patients who received a PPI, H2RA, and no AST, respectively (4/142 vs 1/70 vs 1/80; OR for PPI vs H2RA = 1.92; 95% CI = 0.21-17.47).



This is the first study to describe the incidence of and indications for AST use in the hospitalized hematology/oncology population. There was a high occurrence of AST use, particularly PPIs, in these patients at our institution. Additionally, there was a trend toward an increased risk of HAP and CDAD in patients who received AST during admission.
University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR, USA Georgia Regents Medical Center, Augusta, GA, USA University of Georgia College of Pharmacy, Augusta, GA, USA.
Rachael V
RV
McCaleb
Georgia Regents Medical Center, Augusta, GA, USA University of Georgia College of Pharmacy, Augusta, GA, USA ARGANDHI@gru.edu.
Arpita S
AS
Gandhi
Georgia Regents Medical Center, Augusta, GA, USA.
Stephen Michael
SM
Clark
Georgia Regents Medical Center, Augusta, GA, USA University of Georgia College of Pharmacy, Augusta, GA, USA.
Amber B
AB
Clemmons
D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000328:Adult; D016360:Clostridioides difficile / Q000302:isolation & purification; D003428:Cross Infection / Q000453:epidemiology; D003967:Diarrhea / Q000139:chemically induced / Q000453:epidemiology* / Q000382:microbiology; D017723:Drug Utilization Review / Q000706:statistics & numerical data*; D005260:Female; D006402:Hematologic Diseases / Q000150:complications / Q000188:drug therapy; D006635:Histamine H2 Antagonists / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy; D016017:Odds Ratio; D010437:Peptic Ulcer / Q000453:epidemiology / Q000517:prevention & control*; D011014:Pneumonia / Q000139:chemically induced / Q000453:epidemiology*; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors
D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors
cancer; drug-related problems; hematology; histamine-2 receptor antagonist; oncology; proton pump inhibitor