Overuse of acid-suppressive therapy in hospitalized patients

Am J Gastroenterol. 2000 Nov;95(11):3118-22. doi: 10.1111/j.1572-0241.2000.03259.x.


Objectives: The aims of this study were 1) to determine the frequency of use and indications for prescription of acid-suppressive medications in hospitalized patients, and 2) to determine whether patients who are prescribed these medications for stress ulcer prophylaxis are prescribed them on hospital discharge.

Methods: The use of acid-suppressive medications (histamine-2 receptor antagonists, proton pump inhibitors, and barriers--specifically, famotidine, omeprazole, and sucralfate) was assessed in 226 patients admitted consecutively to a general medical nursing unit of an urban, community, teaching hospital. Chart review was undertaken to determine the type of medication used, timing of prescription, and indication for use.

Results: Of hospitalized patients, 54% were receiving acid-suppressive therapy. Histamine-2 receptor antagonists were used most frequently (62%). In all, 65% of prescriptions were not indicated as determined by consensus review. Among patients put on acid-suppressive therapy for ulcer prophylaxis, 55% were discharged on the therapy.

Conclusions: There is significant overuse of acid-suppressive therapy in hospitalized patients. The problem of placing low-risk patients on ulcer prophylaxis unnecessarily is compounded by discharging these patients with the medication.

MeSH terms

  • Antacids / therapeutic use*
  • Anti-Ulcer Agents / therapeutic use*
  • Drug Utilization
  • Female
  • Histamine H2 Antagonists / therapeutic use
  • Hospitalization
  • Humans
  • Male
  • Patient Discharge
  • Peptic Ulcer / etiology
  • Peptic Ulcer / prevention & control*
  • Proton Pump Inhibitors
  • Stress, Physiological / complications*


  • Antacids
  • Anti-Ulcer Agents
  • Histamine H2 Antagonists
  • Proton Pump Inhibitors