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Choosing Wisely Recommendations

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.