Evaluation of Proton Pump Inhibitor Prescribing Practices for Stress Ulcer Prophylaxis in ICU Patients: A Retrospective Cross-Sectional Study | ||||
| Records of Pharmaceutical and Biomedical Sciences | ||||
| Volume 9, Issue 3, March 2025, Page 82-93 PDF (727.88 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/rpbs.2025.409334.1391 | ||||
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| Authors | ||||
Doaa H. El-Farook1; Ahmed Essam Abou Warda2; Nada Hazem Farrag3; Sayed Gaber4; Mahmoud Tammam5; Ramy M. El Sabaa6; Asmaa S. Mohamed  7
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| 1Clinical Pharmacy department, Faculty of pharmaceutical sciences and drug manufacturing, Misr University for science and technology, Giza, Egypt. | ||||
| 2Clinical Pharmacy Department, Faculty of Pharmacy, October 6 University, Giza, Egypt. | ||||
| 3Clinical Pharmacy, School of Life and Medical Sciences, University of Hertfordshire Hosted by Global Academic Foundation, New Administrative Capital, Egypt. | ||||
| 4Critical Care Medicine, Faculty of Medicine, Cairo University, Giza, Egypt. | ||||
| 5IQVIA, Cairo, Egypt. | ||||
| 6Clinical Pharmacy Department, Faculty of Pharmacy, Menoufia University, Egypt. | ||||
| 7Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy, Port said University, Port said, Egypt. | ||||
| Abstract | ||||
| Background Stress ulcer prophylaxis (SUP) with proton pump inhibitors (PPIs) is widely used in intensive care units (ICUs) to prevent gastrointestinal bleeding in critically ill patients. This study evaluates PPI prescribing patterns in ICU patients, their appropriateness based on clinical risk factors, and associated outcomes, including therapeutic failure and adverse events. Methods This retrospective cross-sectional study analyzed data from 158 adult ICU patients at El Moalmeen Private Hospital in Cairo, Egypt. Researchers collected demographic, clinical, and laboratory data using a structured form. The study evaluated PPI prescribing practices based on recognized major and minor risk factors for stress-related mucosal bleeding, along with instances of therapeutic failure and adverse effects. Results In a study of 158 ICU patients (mean age 63.8 years, 57% male), hypertension (60.1%) and diabetes (41.8%) were prevalent comorbidities, with pneumonia (41.1%) as the leading cause of admission, followed by acute kidney injury and altered consciousness (10.1% each). Only 44.9% of PPI prescriptions were appropriate, with 22.2% supported by major indications and 24.1% by two or more minor indications. However, 55.1% of PPI use lacked clear justification. Therapeutic failure occurred in 12.7% of cases, and Clostridioides difficile infection was noted in 5.1%. Logistic regression identified older age (OR 1.04) and chronic kidney disease (OR 4.98) as significant predictors of PPI overprescription. Conclusion Inappropriate PPI use for SUP remains prevalent in ICU patients. Advanced age and chronic kidney disease are key predictors, highlighting the need for evidence-based guidelines and increased prescriber awareness to optimize therapy and reduce adverse outcomes. | ||||
| Keywords | ||||
| Proton pump inhibitors; Prescription; intensive care units; Stress ulcer prophylaxis; Acid-suppressive therapy | ||||
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