Acid Suppression Therapy in an Internal Medicine Department

Abstract

Background: The use of acid suppression (AST) in the prophylaxis of stress ulcer is well defined in patients in Intensive Care units,
although there is lack of data in the general practice. Appropriate recommendations include: upper gastrointestinal disease or
NSAID-induced gastropathy.
The aims of this study were to determine the frequency and the
predictive factors for inappropriate administration of AST on admission, during the hospitalization and on discharge to the general
practice and to determine the costs to the health care system.
Methods: A retrospective review of clinical files was carried out from the 1st of January to 30th of June of 2010 in our Internal
Medicine department. The medications used were esomeprazole, ranitidine and sucralfate.
Results: we assessed 511 patients with a mean age of 80.5years. 30% of the patients took AST before admission. Their use was
inappropriate in 69% of them. Among hospitalized patients, 89% of patients started AST during the hospitalization, and these 76%
were unnecessary. At discharge, 48% of patients used AST, and most of them (61%) had no such indication.
The inappropriate administration of AST increases the cost per patient.
Conclusion: Results agree with the literature, with a high
frequency of incorrect AST prescription. A more accurate use of AST is recommended to avoid side effects and to reduce costs.