Hospital use of acid-suppressive medications and its fall-out on prescribing in general practice: a 1-month survey

Aliment Pharmacol Ther. 2003 Jun 15;17(12):1503-6. doi: 10.1046/j.1365-2036.2003.01600.x.


Background: Acid-suppressive medications are commonly used in hospitalized patients, but, to date, little is known about the overall use of these drugs in the hospital setting.

Aim: To evaluate the appropriateness of acid-suppressive therapy in a large teaching hospital in northern Italy, and the fall-out of hospital prescription in general practice.

Methods: The use of antisecretory agents was monitored for 1 month in adult patients consecutively admitted to L. Sacco University Hospital by reviewing their clinical charts. The appropriateness of each prescription was reviewed jointly by two consultant gastroenterologists.

Results: A total of 46.8% of 799 hospitalized patients received acid-suppressive therapy. Ranitidine was the most frequently used drug (44.4%), followed by pantoprazole (31.8%) and omeprazole (23.0%). Stress ulcer prophylaxis and the prevention of non-steroidal anti-inflammatory drug-induced ulcer accounted for 60.4% of the indications for use. Overall, 68% of prescriptions were not appropriate as determined by consensus review; 56.4% of patients receiving unnecessary prophylactic treatment whilst in hospital were discharged on therapy, and 46% were still receiving the treatment 3 months later.

Conclusions: Acid-suppressive agents are over-used in hospitalized patients. Most of the inappropriate hospital prescriptions are for ulcer prophylaxis in low-risk patients. This unnecessary use may also induce inappropriate drug consumption in general practice.

MeSH terms

  • Antacids / therapeutic use*
  • Drug Prescriptions / statistics & numerical data
  • Dyspepsia / drug therapy
  • Family Practice
  • Gastroesophageal Reflux / drug therapy
  • Gastrointestinal Hemorrhage / drug therapy
  • Health Services Misuse
  • Histamine Agonists / therapeutic use
  • Hospitalization / statistics & numerical data
  • Humans
  • Peptic Ulcer / drug therapy
  • Practice Patterns, Physicians' / standards*
  • Practice Patterns, Physicians' / statistics & numerical data
  • Proton Pump Inhibitors


  • Antacids
  • Histamine Agonists
  • Proton Pump Inhibitors