Choosing Wisely:

Don’t prescribe medications for stress ulcer prophylaxis to medical inpatients unless at high risk for gastrointestinal complications.

Rationale and Comments: According to published guidelines, medications for stress ulcer prophylaxis are not recommended for adult patients in non-intensive care unit settings. Histamine H2-receptor antagonists and proton pump inhibitors commonly used to treat stress ulcers are associated with adverse drug events and increased medication costs, and commonly enhance susceptibility to community-acquired nosocomial pneumonia and Clostridium difficile. Adherence to therapeutic guidelines will aid health care providers in reducing treatment of patients without clinically important risk factors for gastrointestinal bleeding.
Sponsoring Organizations:
  • Society of Hospital Medicine (Adult)
  • Sources:
  • Expert consensus
  • Disciplines:
  • Gastroenterologic
  • References: • ASHP therapeutic guidelines on stress ulcer prophylaxis. Am J Health Sys Pharm. 1999;56:347-79.

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