Analysis of the use and cost of stress ulcer prophylaxis for surgical inpatients

J Basic Clin Physiol Pharmacol. 2020 Jan 11;30(6):/j/jbcpp.ahead-of-print/jbcpp-2019-0306/jbcpp-2019-0306.xml. doi: 10.1515/jbcpp-2019-0306.


Background Stress ulcer is a superficial and asymptomatic lesion and causes bleeding. As many as 50% of death cases are reported as the result of stress ulcer bleeding. Stress ulcer prophylaxis (SUP) is a drug used to prevent gastrointestinal tract injuries due to stress ulcers. The inappropriate use of SUP drugs can cause adverse drug reactions, and thus SUP drugs are only given to patients in accordance with guidelines in order to avoid the overuse of SUP drugs. The aim of this present study is to analyse the suitability of SUP drug usage based on the criteria from the American Society of Health-System Pharmacists (ASHP) and the drug costs of SUP overuse. Methods An observational descriptive study was conducted from April 24, 2019, to May 17, 2019, in the inpatient surgical ward of Dr. Soetomo General Hospital. Data were obtained from patient medical health records. Results One hundred fifty-two patients used 1404 SUP drugs. Approximately 48% of usage did not suit the ASHP criteria and was considered as medication overuse. The cost of excessive SUP usage during the study period was more than US $65, which is 30.08% of the total drug cost of prescribed stress ulcer drugs. Conclusions The present study suggests that the relatively high excessive drug costs for SUP show a need for monitoring of the application of SUP therapy guidelines.

Keywords: drug costs; overuse; stress ulcer; stress ulcer prophylaxis.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Anti-Ulcer Agents / economics*
  • Anti-Ulcer Agents / therapeutic use*
  • Drug Costs / statistics & numerical data*
  • Female
  • Humans
  • Indonesia
  • Inpatients / psychology*
  • Inpatients / statistics & numerical data
  • Male
  • Middle Aged
  • Prescription Drug Overuse / statistics & numerical data*
  • Retrospective Studies
  • Risk Factors
  • Stomach Ulcer / drug therapy*
  • Stomach Ulcer / economics*
  • Stomach Ulcer / surgery


  • Anti-Ulcer Agents